Integrative Characterization of the Role of IL27 In Melanoma Using Bioinformatics Analysis

BackgroundIL27 has been reported to play dual roles in cancer; however, its effects on the tumor microenvironment (TME), immunotherapy, and prognosis in melanoma remain largely unclear. This study was aimed to uncover the effects of IL27 on TME, immunotherapy and prognosis in patients with melanoma.MethodsRNA-seq data, drug sensitivity data, and clinical data were obtained from TCGA, GEO, CCLE, and CTRP. Log-rank test was used to determine the survival value of IL27. Univariate and multivariate Cox regression analyses were employed to determine the independent predictors of survival outcomes. DAVID and GSEA were used to perform gene set functional annotations. ssGSEA was used to explore the association between IL27 and immune infiltrates. ConsensusClusterPlus was used to classify melanoma tissues into hot tumors or cold tumors.ResultsClinically, IL27 was negatively correlated with Breslow depth (P = 0.00042) and positively associated with response to radiotherapy (P = 0.038). High IL27 expression showed an improved survival outcome (P = 0.00016), and could serve as an independent predictor of survival outcomes (hazard ratio: 0.32 - 0.88, P = 0.015). Functionally, elevated IL27 expression could induce an enhanced immune response and pyroptosis (R = 0.64, P = 1.2e-55), autophagy (R = 0.37, P = 7.1e-17) and apoptosis (R = 0.47, P = 1.1e-27) in patients with melanoma. Mechanistically, elevated IL27 expression was positively correlated with cytotoxic cytokines (including INFG and GZMB), enhanced immune infiltrates, and elevated CD8/Treg ratio (R = 0.14, P = 0.02), possibly driving CD8+ T cell infiltration by suppressing β-catenin signaling in the TME. Furthermore, IL27 was significantly associated with hot tumor state, multiple predictors of response to immunotherapy, and improved drug response in patients with melanoma.ConclusionsIL27 was correlated with enriched CD8+ T cells, desirable therapeutic response and improved prognosis. It thus can be utilized as a promising modulator in the development of cytokine-based immunotherapy for melanoma.

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Bioinformatic Analysis: The Role of LINC00634 in Colorectal Carcinoma

10.21203/rs.3.rs-801188/v1 ◽

2021 ◽

Author(s):

Fang Liu ◽

Fengyihuan Fu ◽

Yuqiang Nie

Keyword(s):

Esophageal Cancer ◽

Regression Analysis ◽

Prognostic Factors ◽

Colorectal Carcinoma ◽

Roc Curve ◽

Cox Regression ◽

Survival Outcomes ◽

Immune Infiltration ◽

The Relationship

Abstract Background: LINC00634 is highly expressed in esophageal cancer, and its depletion can suppress the viability and induce the apoptosis of esophageal cancer cells. However, there is a lack of studies that examine the relationship between LINC00634 expression and the clinicopathological features, survival outcomes, prognostic factors and tumor immune cell infiltration of colorectal carcinoma (CRC) patients.Objective: We aim at investigating the role of LINC00634 in colorectal carcinoma.Methods: We obtained data from the TCGA (The Cancer Genome Atlas) public database, GTEx (Genotype-Tissue Expression) database and clinical samples. Wilcoxon rank-sum test, Kruskal-Wallis test and logistic regression analysis were employed to assess the relationship between LINC00634 expression and the clinicopathological characteristics of CRC patients. Receiver operating characteristic (ROC) curve was constructed to evaluate the ability of LINC00634 for distinguishing between CRC patients and normal subjects based on the area under the curve (AUC) score. Univariate and multivariate analyses were conducted to evaluate the association between prognostic factors and survival outcomes. Kaplan-Meier curves and Cox regression analysis were employed to determine the contribution of LINC00634 expression to the prognosis of colorectal carcinoma patients. Immune infiltration analysis and Gene Set Enrichment Analysis (GSEA) were conducted to identify the significantly involved functions of LINC00634. Finally, a nomogram was constructed for internal verification based on the Cox regression data.Results: The expression of LINC00634 was upregulated in CRC patients, and markedly associated with N stage, residual tumor, pathological stage, and overall survival (OS) event. ROC curve showed that LINC00634 had strong diagnostic and prognostic abilities (AUC=0.74). The high expression of LINC00634 could predict poor disease specific survival (DSS; P=0.008) and poor overroll survival (OS;P<0.01). The expression of LINC00634 was independently associated with OS in CRC patients (P=0.019). GSEA and immune infiltration analysis demonstrated that LINC00634 expression was involved in gene transcription, epigenetic regulation and the functions of certain types of immune infiltrating cells. The c-index of the nomogram was 0.772 (95％CI: 0.744-0.799).Conclusions: Our study reveals that LINC00634 can serve as a potential prognostic biomarker for CRC patients.

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The role of serum carcinoembryonic antigen in predicting objective responses to chemotherapy and overall survival in patients with non-small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e18084 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e18084-e18084

Author(s):

Hongbing Liu

Keyword(s):

Protective Factor ◽

Cox Regression ◽

Rank Test ◽

Small Cell Lung ◽

Baseline Serum ◽

Log Rank Test ◽

Kaplan Meier ◽

Serum Cea ◽

Nsclc Patients

e18084 Background: Previous studies indicated the carcinoembryonic antigen (CEA) could predict the therapeutic objective response (OR) and overall survival (OS) of patients with cancers, including non-small cell lung cancer (NSCLC). However, the role it could play in evaluating therapeutic responses and OS in patients with NSCLC requires further elucidation. Herein, we investigated the potential role of CEA in predicting OR and OS in patients with NSCLC. Methods: 689 patients with NSCLC were enrolled between January 2000 and August 2011. The correlations between the CEA levels and OR or OS were examined via statistical analyses including the chi-squared test, logistical regression, paired-samples t-test, receiver operator characteristic curve, Kaplan-Meier survival analysis, log-rank test and Cox regression model. Results: The calculated cut-off for predicting an OR to chemotherapy in patients with NSCLC was a reduction of 5.28% in serum CEA. This value demonstrated a sensitivity of 61.3% and a specificity of 62.4%. Serum CEA levels significantly decreased after two cycles of chemotherapy in NSCLC patients (t = 2.196, P = 0.031). The Kaplan-Meier survival analysis indicated no significant correlation between baseline CEA and OS (log rank test =0.079). However, according to the Cox regression analysis the number of distant metastatic organs (=1 and ≥2) was the independent risk factor of the OS (P = 0.026; P =0.003), and the cycle numbers of chemotherapy was the protective factor for OS in patients with NSCLC (P=0.011).More importantly, baseline serum CEA was significantly associated with lung adenocarcinoma and adenosquamous subtypes (P = 0.014; P = 0.017, respectively). Conclusions: Our study shows that baseline serum CEA was significantly associated with lung adenocarcinoma and adenosquamous subtypes. While the baseline level of serum CEA was not a prognostic factor, the post-treatment reduction of serum CEA level can predict the OR in patients with NSCLC,. The number of chemotherapy cycles was the independent protective factor, while the numbers of distant metastatic organs was the independent risk factor for NSCLC patients’ OS.

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The clinical utility of neuron-specific enolase serum levels as a biomarker for Merkel cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.9570 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 9570-9570 ◽

Cited By ~ 1

Author(s):

Linde M. van Veenendaal ◽

Eduardo Bertolli ◽

Catharina M. Korse ◽

W. Martin. C. Klop ◽

Margot Et Tesselaar ◽

...

Keyword(s):

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Cox Regression ◽

Neuron Specific Enolase ◽

Distant Metastases ◽

Serum Levels ◽

Optimal Level ◽

Rank Test ◽

Merkel Cell

9570 Background: To date no adequate biomarker for Merkel Cell carcinoma (MCC) has been identified. The introduction of immunotherapy (IT) for metastatic MCC increases the need for a biomarker. Serum Neuron-specific enolase (NSE) has already been tested and is commonly used as a biomarker for several small cell malignancies. However, the role of NSE in MCC is still unclear. Aim: To investigate the role of NSE as a biomarker in MCC. Methods: A prospective cohort of MCC patients treated from 2016 to July 2018 was analyzed. Kaplan Meier curves with log rank test, Cox regression and mixed models were used to analyze NSE. A separate evaluation was performed for patients treated with IT. Results: A total of 78 patients (42 males, median age 71 years, stage I&II, III and IV MCC in 37(47%), 39(50%) and 2(3%) patients at time of diagnosis with 474 NSE levels (median 15 ; IQR 12,6-22 ng/ml were included. Baseline NSE (n=36) had no influence on survival or progression. During follow-up (FU) NSE levels correlated with tumorload (p=0,01) with increase of 15 ng/ml per class (no tumorload, localized MCC, nodal and distant metastases, respectively). NSE level during FU was able to detect progression (AUC 0,89). Several cut off values were evaluated. A NSE of 18,2 ng/ml was considered the most optimal level for clinical use (sensitivity 91%, specificity 78%, PPV 48%, NPV 98% to detect progression). During IT (n=16; 195 NSE values) all complete responders (n=7) had a normalized NSE (<18,2 ng/ml), all partial responders (n=3) had a decreasing NSE. In non-responders (n=6) all NSE levels remained elevated, one patient responded after switching to different IT with normalizing NSE values. Conclusions: NSE seems to be a valuable biomarker in MCC. NSE correlates with tumorload; is able to rule out progression and distinguishes responders from non-responders during IT.

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Impact of angiotensin system inhibitors (ASI) on outcomes in patients (pts) with metastatic renal cell carcinoma (mRCC): Results from a pooled clinical trials database.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.437 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 437-437 ◽

Cited By ~ 3

Author(s):

Rana R. McKay ◽

Gustavo Enrique Rodriguez ◽

Xun Lin ◽

Ronit Simantov ◽

Toni K. Choueiri

Keyword(s):

Clinical Trials ◽

Cox Regression ◽

Multivariable Analysis ◽

Progression Free Survival ◽

Risk Groups ◽

Angiotensin Converting Enzyme Inhibitors ◽

Phase Iii ◽

Survival Outcomes ◽

Converting Enzyme Inhibitors

437 Background: Increasing evidence suggests that angiotensin II modulates angiogenesis and tumorigenesis. In this study, we utilized a clinical trials database to evaluate the role of ASIs (angiotensin-converting enzyme inhibitors and angiotension-receptor blockers) on survival outcomes in pts with mRCC. Methods: We conducted an analysis of pts with mRCC treated from 2003-2013 on phase III (NCT00083889, NCT00065468, NCT00678392, NCT00474786, NCT00631371, NCT00920816) and II clinical trials (NCT00054886, NCT00077974, NCT00267748, NCT00338884, NCT00137423, NCT00835978). We evaluated pts treated with ASIs at baseline or within the first 30 days of study. Statistical analyses were performed using Cox regression and the Kaplan-Meier method. Results: We identified 4,736 pts treated with sunitinib (n=1,059), sorafenib (n=772), axitinib (n=896), temsirolimus (TEM) (n=457), TEM + interferon-alfa (IFN-α) (n=208), bevacizumab (BEV) + TEM (n=393), BEV + IFN-α (n=391), or IFN-α (n=560). Most pts were < 65 years of age (69%), male (71%), with clear-cell histology (89%) and prior nephrectomy (70%). With regard to International mRCC Database Consortium risk groups, 14%, 42%, and 24% had favorable, intermediate, and poor-risk disease, respectively. 1383 (29%) pts received treatment with an ASI. Baseline hypertension was present in 84% of ASI users and 33% of ASI non-users. ASI use was associated with improved progression-free survival (PFS) and overall survival (OS) when compared to pts who did not receive an ASI (Table). This association was retained in multivariable analysis adjusted for age, gender, presence of bone metastases, and risk groups. Conclusions: This is the largest retrospective study to date evaluating the role of ASIs on outcomes in cancer pts. In this analysis, we demonstrate that concomitant use of ASIs may improve survival outcomes in pts with mRCC treated in the era of targeted therapy. [Table: see text]

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Low Expression of FOXP2 is Associated with Better Prognosis in Glioblastoma.

10.21203/rs.3.rs-52146/v1 ◽

2020 ◽

Author(s):

Julio Plata-Bello ◽

Helga Fariña-Jerónimo ◽

Isabel Betancor ◽

Eduardo Salido

Keyword(s):

Protein Level ◽

Cox Regression ◽

Statistical Tests ◽

Case Series ◽

Rank Test ◽

Special Focus ◽

Case Series Study ◽

Worse Prognosis ◽

Low Expression

Abstract FOXP2 expression has been associated with the prognosis of some tumors, but the role of FOXP2 in glioblastoma has not been studied in-depth until now. The aim of the present work is to study the role of FOXP2 as a prognostic biomarker in glioblastoma.This is a retrospective observational case series study in which the expression of FOXP2 has been analyzed both at the protein level (immunohistochemistry) and at the mRNA level (RNAseq, in a cohort of glioblastoma patients from The Cancer Genome Atlas [TCGA] database). Other molecular and clinical data have also been included in the study, with special focus on miRNA expression data.Survival analysis using Log-Rank test and COX-regression have been used. Non-parametric statistical tests were also used to study differences between low and high FOXP2 expression groups.Patients with a high expression of FOXP2 protein showed a worse prognosis than those patients with low expression in both, progression free survival (PFS) (HR=1.711; p=0.034) and overall survival (OS) (HR=1.809;p=0.014). These associations were still statistically significant in multivariate analysis.No prognostic association was found with FOXP2 RNA expression. Interestingly, two miRNAs that target FOXP2 (hsa-miR-181a-2-3p and hsa-miR-20a-3p) showed an interaction effect on OS with FOXP2 expression. A low level of these miRNAs expression was associated with a significantly worse prognosis in patients with high FOXP2 RNA expression.Higher expression of FOXP2 at the protein level is associated with a worse prognosis. This protein expression may be regulated by the expression of specific miRNAs that target FOXP2 mRNA: hsa-miR-181a-2-3p and hsa-miR-20a-3p.

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Outcome of Primary Intraosseous Carcinoma: Cases Review of Single Institution

10.21203/rs.3.rs-966807/v1 ◽

2021 ◽

Author(s):

en long ◽

Dongling You ◽

Shubin Wang ◽

Shun Lu ◽

Peng Xu ◽

...

Keyword(s):

Adjuvant Therapy ◽

Cox Regression ◽

Multivariate Analyses ◽

Univariate Analysis ◽

Progression Free Survival ◽

Rank Test ◽

Therapeutic Modalities ◽

Well Differentiated ◽

Intraosseous Carcinoma

Abstract Objective: The purpose of this study was to investigate the prognostic factors and treatment of primary intraosseous carcinoma (PIOC).Methods: Patients who diagnosed with PIOC and received treatment in Sichuan cancer hospital from 1996 to 2020 were followed up and retrospectively reviewed. Univariate and multivariate analyses base on clinical-pathological characteristics and therapeutic modalities were performed using the Log rank test and Cox regression model respectively.Result: A total of 28 patients were included in the study, with a mean age of 60 years (60±10.11). The 2-year and 5-year overall survival (OS) were 60.7% and 38.5% respectively. In the univariate analysis, surgery combined with adjuvant therapy improved the OS compared with surgery or radiotherapy alone (P=0.035), and patients received postoperative adjuvant radiotherapy had a higher OS than those who received radical radiotherapy (P = 0.01). In addition, patients with well differentiated tumors tent to have increased progression free survival (PFS) (P=0.01). Multivariate analyses showed that radiotherapy was independent indicators for OS (HR: 0.212, 95% CI: 0.068–0.660, P = 0.007).Conclusion: surgery combined with adjuvant therapy is the superior treatment strategy for primary intraosseous carcinoma at present. This study is the first to report the important role of radiotherapy in the treatment of primary intraosseous carcinoma.Mini Abstract：surgery plus adjuvant therapy is the preferred treatment for primary intraosseous carcinoma and it is first to illustrate the important role of radiotherapy.

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Pan-cancer immunogenomic analyses reveal genotype-immunophenotype relationships and predictors of response to checkpoint blockade

10.1101/056101 ◽

2016 ◽

Cited By ~ 52

Author(s):

Pornpimol Charoentong ◽

Francesca Finotello ◽

Mihaela Angelova ◽

Clemens Mayer ◽

Mirjana Efremova ◽

...

Keyword(s):

Immune Cell ◽

The Cancer Genome Atlas ◽

Tumor Escape ◽

Predictors Of Response ◽

Cancer Genome Atlas ◽

Tumor Immunogenicity ◽

Immune Oncology ◽

Cancer Germline

SUMMARYThe Cancer Genome Atlas revealed the genomic landscapes of common human cancers. In parallel, immunotherapy with checkpoint blockers is transforming the treatment of advanced cancers. As only a minority of the patients is responsive to checkpoint blockers, the identification of predictive markers and the mechanisms of resistance is a subject of intense research. To facilitate understanding of the tumor-immune cell interactions, we characterized the intratumoral immune landscapes and the cancer antigenomes from 20 solid cancers, and created The Cancer Immunome Atlas (http://tcia.at). Cellular characterization of the immune infiltrates revealed a role of cancer-germline antigens in spontaneous immunity and showed that tumor genotypes determine immunophenotypes and tumor escape mechanisms. Using machine learning we identified determinants of tumor immunogenicity and developed a scoring scheme for the quantification termed immunophenoscore. The immunophenoscore was superior predictor of response to anti-CTLA-4 and anti-PD-1 antibodies in two independent validation cohorts. Our findings and the developed resource may help informing cancer immunotherapy and facilitate the development of precision immune-oncology.

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Thymidine phosphorylase expression in metastatic kidney cancer as a potential predictor of outcome in patients treated with sunitinib.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15091 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15091-e15091

Author(s):

Manuela Miscoria ◽

Carla Di Loreto ◽

Fabio Puglisi ◽

Paul Gerard Murray ◽

Laura Deroma ◽

...

Keyword(s):

Multivariate Analysis ◽

Thymidine Phosphorylase ◽

Cox Regression ◽

Univariate Analysis ◽

Objective Response ◽

Nucleotide Metabolism ◽

Rank Test ◽

Pyrimidine Nucleotide ◽

Thymidine Phosphorylase Expression

e15091 Background: Aberrant tumour angiogenesis is a hallmark of Renal Cell Carcinoma (RCC). Sunitinib is a small molecule targeting angiogenesis licensed for advanced RCC (aRCC) treatment. Thymidine Phosphorylase (TP) is an enzyme involved in pyrimidine nucleotide metabolism with a role in angiogenesis upregulation in cancer. In RCC, TP expression is associated with poor prognosis. We studied TP immunohistochemical expression in RCC samples and its association with the outcomes in a cohort of aRCC patients treated with sunitinib. Methods: We identified 59 consecutive patients with aRCC treated with sunitinib at our Institution. Nuclear (N) and cytoplasm (C) scoring for TP, using the validated Tsuda scoring, was performed. TP expression and clinico-pathological variables were studied to assess their association with the outcome of S therapy. The log rank test has been used for the univariate analysis and the Cox regression for the multivariate analysis. Results: Thirty-four patients received sunitinib as first line treatment. Fifty patients (84%) had clear cell RCC, 7 (12%) showed sarcomatoid features. Forty-five patients (76%) achieved either an objective response or stable disease. At the time of the analysis 32 patients had died, 46 had progressed and 41 had stopped the treatment. After an average follow up of 21 months, median OS and PFS were 21.2, 12.8 months respectively. N TP staining was positive in 19 patients (32%) and C staining in 36 (61%) patients. A significant association was observed between the N and C expression (p=0.004). The univariate analysis identified an association between N TP expression and longer OS (29.8 vs 17.8 months; p=0.0463) even if the association was not significant in the multivariate analysis (HR=0.56; CI 0.19-1.6). No associations were noted with PFS. Conclusions: In our study TP was overexpressed in a significant percentage of kidney cancers. In patients treated with sunitinib, N TP expression was associated with better OS. The results of the multivariate analysis were probably affected by the limited sample size. Larger and prospective studies are necessary to define the role of TP in RCC.

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Real-world outcomes among patients (pts) treated with gemcitabine (GEM)-based therapy post-FOLFIRINOX (FFOX) failure in advanced pancreatic cancer (APC).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.303 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 303-303

Author(s):

Erica S Tsang ◽

Jennifer L. Spratlin ◽

Winson Y. Cheung ◽

Christina Kim ◽

Shiying Kong ◽

...

Keyword(s):

Cox Regression ◽

Advanced Pancreatic Cancer ◽

Population Based ◽

Rank Test ◽

Survival Outcomes ◽

Test Results ◽

Publicly Funded ◽

Cox Regression Analysis ◽

Treatment Regimens ◽

Kaplan Meier

303 Background: Limited evidence exists for the selection of chemotherapy in APC after first-line (1stL) FFOX. Gemcitabine/nab-paclitaxel (GEMNAB) is publicly funded for second-line (2ndL) use in the provinces of Alberta (AB) and Manitoba (MB), but is not covered in British Columbia (BC). We compared population-based outcomes by region to examine the utility of 2ndL GEMNAB versus GEM alone. Methods: We identified pts treated with 1stL FFOX between 2013-2015 across BC, AB, and MB. Baseline characteristics and treatment regimens were compared between AB/MB and BC. Survival outcomes were assessed by the Kaplan-Meier, and compared with log-rank test. Results: 370 pts treated with 1stL FFOX were identified (145 AB/MB, 225 BC), with a median age of 61y, 42% female, and 68% with metastatic disease (similar in both groups). Receipt of 2ndL therapy was 49% AB/MB vs 44% BC ( p = 0.35), and time from diagnosis to 2ndL therapy measured 7.6 mos AB/MB versus 9.4 mos BC ( p = 0.1). The distribution of 2ndL gemcitabine use was: 72% GEMNAB, 23% GEM in AB/MB versus 27% GEMNAB, 66% GEM in BC ( p < 0.001). Median overall survival (OS) from diagnosis was similar: 12.4 mos in AB/MB versus 10.9 mos in BC ( p = 0.75). On Cox regression analysis, region was not significant. A secondary survival analysis by 2ndL regimen demonstrated a median OS of 18.0 mos with GEMNAB versus 14.3 mos GEM ( p < 0.01). Conclusions: In our population-based comparison of APC pts treated with 1stL FFOX, survival outcomes were comparable regardless of publicly funded access to 2ndL GEMNAB versus GEM. OS by regimen favored 2ndL GEMNAB, but patient selection may be largely responsible for this difference. Randomized trials are needed to demonstrate the benefit of GEMNAB post-FFOX in APC.

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Modeling the Contribution of Male Testosterone Levels to the Duration of Positive COVID Testing among Hospitalized Male COVID-19 Patients

Diagnostics ◽

10.3390/diagnostics11040581 ◽

2021 ◽

Vol 11 (4) ◽

pp. 581

Author(s):

Stefano Salciccia ◽

Michael L. Eisenberg ◽

Martina Maggi ◽

Silvia Lai ◽

Claudio Maria Mastroianni ◽

...

Keyword(s):

Immune Response ◽

Viral Infections ◽

Cox Regression ◽

Control Strategies ◽

Rank Test ◽

Total Testosterone ◽

Oxygen Administration ◽

Kaplan Meier ◽

Testosterone Effect

Background: A growing body of evidence is emerging suggesting testosterone can affect all cells involved in the immune response to both bacterial and viral infections, and the testosterone effect on the immune response could explain the greater susceptibility of men to infections including COVID-19. We aimed to explore the predictive role of male serum total testosterone (TT) levels on the time till viral negativity testing among hospitalized COVID-19 patients. Methods: The univariate effect of risk factors for the duration of COVID-19 viral positivity was evaluated using the log-rank test and Kaplan–Meier estimates. A multivariable Cox regression model was developed to test the role of TT levels and the subsequent odds for shorter viral positivity intervals. Results: Increasing serum TT levels and the need for an oxygen administration strategy were independently predictive for respectively reduced and increased days to negativization (Hazard Ratio [HR]: 1.39, 95% CI: 0.95–2.03 and HR: 0.19, 95% CI: 0.03–1.18). Conclusion: Baseline higher TT levels for male COVID-19 patients at hospital admission are associated with shorter durations of positive COVID-19 testing and thus viral clearance. Our preliminary findings might play a relevant to help pandemic control strategies if these will be verified in future larger multicentric and possibly randomized trials.

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