Prognostic bioindicators in severe COVID-19 patients.
Aged
Biomarkers
/ blood
C-Peptide
/ blood
C-Reactive Protein
/ metabolism
COVID-19
/ blood
Case-Control Studies
Cytokines
/ blood
Female
Humans
Inflammation Mediators
/ blood
Interleukin-6
/ blood
Italy
/ epidemiology
Male
Middle Aged
Mucin-1
/ blood
Pandemics
Prognosis
SARS-CoV-2
Severity of Illness Index
Biomarkers
COVID-19
IL-6
KL-6
Journal
Cytokine
ISSN: 1096-0023
Titre abrégé: Cytokine
Pays: England
ID NLM: 9005353
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
06
07
2020
revised:
17
01
2021
accepted:
18
01
2021
pubmed:
7
2
2021
medline:
30
3
2021
entrez:
6
2
2021
Statut:
ppublish
Résumé
Severe acute respiratory syndrome caused by novel coronavirus 2 (SARS-CoV-2) emerged in Wuhan (China) in December 2019. Here we evaluated a panel of biomarkers to phenotype patients and to define the role of immuno-inflammatory mediators as biomarkers of severity. Serum samples were obtained from 24 COVID-19 patients on admission to hospital, before any treatment or infusion of intravenous steroids or invasive ventilation. KL-6 IL-6 and C-peptide were measured by chemiluminescent enzyme immunoassay. IL-6 assay was validated for accuracy and precision. The validity of variables used to distinguish severe from mild-to-moderate patients was assessed by areas under curves (AUC) of the receiver operating characteristic (ROC) and logistic regression was performed to combine parameters of the two groups. In the severe group, IL-6, CRP and KL-6 concentrations were significantly higher than in mild-to-moderate patients. KL-6, IL-6 and CRP concentrations were directly correlated with each other. ROC curve analysis of the logistic regression model including IL-6, KL-6 and CRP showed the best performance with an AUC of 0.95. Besides corroborating previous reports of over-expression of IL-6 in severe COVID-19 patients requiring mechanical ventilation, analytical determination of other mediators showed that IL-6 concentrations were correlated with those of KL-6 and CRP. The combination of these three prognostic bioindicators made it possible to distinguish severe COVID-19 patients with poor prognosis from mild-to-moderate patients.
Sections du résumé
BACKGROUND
Severe acute respiratory syndrome caused by novel coronavirus 2 (SARS-CoV-2) emerged in Wuhan (China) in December 2019. Here we evaluated a panel of biomarkers to phenotype patients and to define the role of immuno-inflammatory mediators as biomarkers of severity.
MATERIALS AND METHODS
Serum samples were obtained from 24 COVID-19 patients on admission to hospital, before any treatment or infusion of intravenous steroids or invasive ventilation. KL-6 IL-6 and C-peptide were measured by chemiluminescent enzyme immunoassay. IL-6 assay was validated for accuracy and precision. The validity of variables used to distinguish severe from mild-to-moderate patients was assessed by areas under curves (AUC) of the receiver operating characteristic (ROC) and logistic regression was performed to combine parameters of the two groups.
RESULTS
In the severe group, IL-6, CRP and KL-6 concentrations were significantly higher than in mild-to-moderate patients. KL-6, IL-6 and CRP concentrations were directly correlated with each other. ROC curve analysis of the logistic regression model including IL-6, KL-6 and CRP showed the best performance with an AUC of 0.95.
CONCLUSIONS
Besides corroborating previous reports of over-expression of IL-6 in severe COVID-19 patients requiring mechanical ventilation, analytical determination of other mediators showed that IL-6 concentrations were correlated with those of KL-6 and CRP. The combination of these three prognostic bioindicators made it possible to distinguish severe COVID-19 patients with poor prognosis from mild-to-moderate patients.
Identifiants
pubmed: 33548798
pii: S1043-4666(21)00035-1
doi: 10.1016/j.cyto.2021.155455
pmc: PMC7843114
pii:
doi:
Substances chimiques
Biomarkers
0
C-Peptide
0
Cytokines
0
IL6 protein, human
0
Inflammation Mediators
0
Interleukin-6
0
MUC1 protein, human
0
Mucin-1
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
155455Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.
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