Macrophage Migration Inhibitory Factor (MIF) Plasma Concentration in Critically Ill COVID-19 Patients: A Prospective Observational Study

Diagnostics, vol. 11, pp. 332

Abstract

Mortality in critically ill coronavirus disease 2019 (COVID-19) patients is high and pharmacological treatment strategies remain limited. Early-stage predictive biomarkers are needed to identify patients with a high risk of severe clinical courses and to stratify treatment strategies. Macrophage migration inhibitory factor (MIF) was previously described as a potential predictor for the outcome of critically ill patients and for acute respiratory distress syndrome (ARDS), a hallmark of severe COVID-19 disease. This prospective observational study evaluates the predictive potential of MIF for the clinical outcome after severe COVID-19 infection. Plasma MIF concentrations were measured in 36 mechanically ventilated COVID-19 patients over three days after intensive care unit (ICU) admission. Increased compared to decreased MIF was significantly associated with aggravated organ function and a significantly lower 28-day survival (sequential organ failure assessment (SOFA) score; 8.2 ± 4.5 to 14.3 ± 3, p = 0.009 vs. 8.9 ± 1.9 to 12 ± 2, p = 0.296; survival: 56% vs. 93%; p = 0.003). Arterial hypertension was the predominant comorbidity in 85% of patients with increasing MIF concentrations (vs. decreasing MIF: 39%; p = 0.015). Without reaching significance, more patients with decreasing MIF were able to improve their ARDS status (p = 0.142). The identified association between an early MIF response, aggravation of organ function and 28-day survival may open future perspectives for biomarker-based diagnostic approaches for ICU management of COVID-19 patients.

Authors 11

1. Christian Bleilevens corresponding Aachen Department of Anesthesiology, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Anesthesiology, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

2. Josefin Soppert Aachen Department of Intensive Care and Intermediate Care Institute of Molecular Cardiovascular Research

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Intensive Care and Intermediate Care, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

   Institute of Molecular Cardiovascular Research, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

3. Adrian Hoffmann

   LMU Klinikum · Institut für Schlaganfall- und Demenzforschung · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Chair of Vascular Biology, Institute for Stroke and Dementia Research (ISD), Klinikum, Ludwig-Maximilians-Universität (LMU) München, 81377 Munich, Germany

   Department of Anesthesiology, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU) München, 81377 Munich, Germany

4. Thomas Breuer Aachen Department of Intensive Care and Intermediate Care

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Intensive Care and Intermediate Care, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

5. Jürgen Bernhagen

   LMU Klinikum · Munich Cluster for Systems Neurology · Institut für Schlaganfall- und Demenzforschung · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Chair of Vascular Biology, Institute for Stroke and Dementia Research (ISD), Klinikum, Ludwig-Maximilians-Universität (LMU) München, 81377 Munich, Germany

   Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany

   Munich Heart Alliance, 80802 Munich, Germany

6. Lukas Märtin Aachen Department of Intensive Care and Intermediate Care

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Intensive Care and Intermediate Care, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

7. Lara Stiehler Aachen Department of Intensive Care and Intermediate Care

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Intensive Care and Intermediate Care, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

8. Gernot Marx Aachen Department of Intensive Care and Intermediate Care

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Intensive Care and Intermediate Care, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

9. Michael Dreher Aachen Department of Pneumology, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Pneumology, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany

10. Christian Stoppe

    Universitätsklinikum Würzburg

    Affiliation as printed

    Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital, Wuerzburg, D-97080 Würzburg, Germany

11. Tim-Philipp Simon Aachen Department of Intensive Care and Intermediate Care

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Department of Intensive Care and Intermediate Care, Medical Faculty Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, D-52074 Aachen, Germany