{"title":"白细胞介素-6、血清铁蛋白和 d-二聚体在 COVID-19 住院患者中的作用。","authors":"Praveen Gupta , Anunay Gupta , Sandeep Bansal , Monica Sharma , Sumita Saluja , Ira Balakrishnan , Kapil Gupta","doi":"10.1016/j.cyto.2024.156776","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Various studies have observed an association between interleukin-6 (IL-6), serum ferritin, <span>d</span>-dimer, and in-hospital mortality in COVID-19 patients. However, multivariate regression analysis was not done in the majority of the studies, Also, the role of interleukin-6 (IL-6), serum ferritin, and <span>d</span>-dimer in hospitalized COVID-19 patients was not adequately studied and reported from our region.</div></div><div><h3>Method</h3><div>It was a retrospective cohort study in which the serum IL-6, serum ferritin, and <span>d</span>-dimer of 305 hospitalized COVID-19 patients were analyzed, and their association with mortality was determined.</div></div><div><h3>Results</h3><div>In COVID-19 patients, the levels of IL-6 (<em>P = 0.007</em>), serum ferritin (<em>P = 0.011</em>), and <span>d</span>-dimer (<em>P = 0.004</em>) were significantly elevated in patients with severe SARS-CoV-2 illness (SpO2 < 90 % at admission). IL-6 levels were significantly elevated (186 pg/ml vs. 215 pg/ml, <em>P = 0.003</em>) in non-survivors compared to survivors. However, <span>d</span>-dimer (mg/ml) (<em>P = 0.129)</em> and serum ferritin (mg/ml) (<em>P = 0.051</em>) levels were similar between the two groups. The ROC curve (receiver operating characteristic curve) analysis showed a significant but poor area under the curve (AUC) between elevated IL-6 (>208 pg/ml) and in-hospital mortality (<em>P <</em> 0.008, AUC = 0.61). Kaplan-Meir survival analysis showed poor survival in patients with elevated IL-6 (>208 pg/ml) (<em>P<!--> </em>by log-rank: 0.010) and elevated <span>d</span>-dimer (>1780 mg/ml) (<em>P</em> by log-rank: 0.036). The multivariate cox-regression analysis did not show any association between IL-6, serum ferritin, <span>d</span>-dimer, and in-hospital mortality (<em>P</em> > 0.05). Also, no association was found between serum levels of IL-6, serum ferritin, <span>d</span>-dimer, and the use of a ventilator (<em>P > 0.05)</em> and the severity of SARS-CoV-2 illness (<em>P > 0.05</em>) on multivariate binary logistic regression analysis.</div></div><div><h3>Conclusion</h3><div>In this study, the serum levels of IL-6, serum ferritin, and <span>d</span>-dimer were not associated with in-hospital mortality in hospitalized COVID-19 patients on multivariate cox-regression analysis, and were the markers of severe SARS-CoV-2 illness.</div></div>","PeriodicalId":297,"journal":{"name":"Cytokine","volume":"184 ","pages":"Article 156776"},"PeriodicalIF":3.7000,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of interleukin-6, serum ferritin, and d-dimer in hospitalized COVID-19 patients\",\"authors\":\"Praveen Gupta , Anunay Gupta , Sandeep Bansal , Monica Sharma , Sumita Saluja , Ira Balakrishnan , Kapil Gupta\",\"doi\":\"10.1016/j.cyto.2024.156776\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Various studies have observed an association between interleukin-6 (IL-6), serum ferritin, <span>d</span>-dimer, and in-hospital mortality in COVID-19 patients. However, multivariate regression analysis was not done in the majority of the studies, Also, the role of interleukin-6 (IL-6), serum ferritin, and <span>d</span>-dimer in hospitalized COVID-19 patients was not adequately studied and reported from our region.</div></div><div><h3>Method</h3><div>It was a retrospective cohort study in which the serum IL-6, serum ferritin, and <span>d</span>-dimer of 305 hospitalized COVID-19 patients were analyzed, and their association with mortality was determined.</div></div><div><h3>Results</h3><div>In COVID-19 patients, the levels of IL-6 (<em>P = 0.007</em>), serum ferritin (<em>P = 0.011</em>), and <span>d</span>-dimer (<em>P = 0.004</em>) were significantly elevated in patients with severe SARS-CoV-2 illness (SpO2 < 90 % at admission). IL-6 levels were significantly elevated (186 pg/ml vs. 215 pg/ml, <em>P = 0.003</em>) in non-survivors compared to survivors. However, <span>d</span>-dimer (mg/ml) (<em>P = 0.129)</em> and serum ferritin (mg/ml) (<em>P = 0.051</em>) levels were similar between the two groups. The ROC curve (receiver operating characteristic curve) analysis showed a significant but poor area under the curve (AUC) between elevated IL-6 (>208 pg/ml) and in-hospital mortality (<em>P <</em> 0.008, AUC = 0.61). Kaplan-Meir survival analysis showed poor survival in patients with elevated IL-6 (>208 pg/ml) (<em>P<!--> </em>by log-rank: 0.010) and elevated <span>d</span>-dimer (>1780 mg/ml) (<em>P</em> by log-rank: 0.036). The multivariate cox-regression analysis did not show any association between IL-6, serum ferritin, <span>d</span>-dimer, and in-hospital mortality (<em>P</em> > 0.05). Also, no association was found between serum levels of IL-6, serum ferritin, <span>d</span>-dimer, and the use of a ventilator (<em>P > 0.05)</em> and the severity of SARS-CoV-2 illness (<em>P > 0.05</em>) on multivariate binary logistic regression analysis.</div></div><div><h3>Conclusion</h3><div>In this study, the serum levels of IL-6, serum ferritin, and <span>d</span>-dimer were not associated with in-hospital mortality in hospitalized COVID-19 patients on multivariate cox-regression analysis, and were the markers of severe SARS-CoV-2 illness.</div></div>\",\"PeriodicalId\":297,\"journal\":{\"name\":\"Cytokine\",\"volume\":\"184 \",\"pages\":\"Article 156776\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cytokine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1043466624002801\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BIOCHEMISTRY & MOLECULAR BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cytokine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1043466624002801","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
Role of interleukin-6, serum ferritin, and d-dimer in hospitalized COVID-19 patients
Background
Various studies have observed an association between interleukin-6 (IL-6), serum ferritin, d-dimer, and in-hospital mortality in COVID-19 patients. However, multivariate regression analysis was not done in the majority of the studies, Also, the role of interleukin-6 (IL-6), serum ferritin, and d-dimer in hospitalized COVID-19 patients was not adequately studied and reported from our region.
Method
It was a retrospective cohort study in which the serum IL-6, serum ferritin, and d-dimer of 305 hospitalized COVID-19 patients were analyzed, and their association with mortality was determined.
Results
In COVID-19 patients, the levels of IL-6 (P = 0.007), serum ferritin (P = 0.011), and d-dimer (P = 0.004) were significantly elevated in patients with severe SARS-CoV-2 illness (SpO2 < 90 % at admission). IL-6 levels were significantly elevated (186 pg/ml vs. 215 pg/ml, P = 0.003) in non-survivors compared to survivors. However, d-dimer (mg/ml) (P = 0.129) and serum ferritin (mg/ml) (P = 0.051) levels were similar between the two groups. The ROC curve (receiver operating characteristic curve) analysis showed a significant but poor area under the curve (AUC) between elevated IL-6 (>208 pg/ml) and in-hospital mortality (P < 0.008, AUC = 0.61). Kaplan-Meir survival analysis showed poor survival in patients with elevated IL-6 (>208 pg/ml) (P by log-rank: 0.010) and elevated d-dimer (>1780 mg/ml) (P by log-rank: 0.036). The multivariate cox-regression analysis did not show any association between IL-6, serum ferritin, d-dimer, and in-hospital mortality (P > 0.05). Also, no association was found between serum levels of IL-6, serum ferritin, d-dimer, and the use of a ventilator (P > 0.05) and the severity of SARS-CoV-2 illness (P > 0.05) on multivariate binary logistic regression analysis.
Conclusion
In this study, the serum levels of IL-6, serum ferritin, and d-dimer were not associated with in-hospital mortality in hospitalized COVID-19 patients on multivariate cox-regression analysis, and were the markers of severe SARS-CoV-2 illness.
期刊介绍:
The journal Cytokine has an open access mirror journal Cytokine: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
* Devoted exclusively to the study of the molecular biology, genetics, biochemistry, immunology, genome-wide association studies, pathobiology, diagnostic and clinical applications of all known interleukins, hematopoietic factors, growth factors, cytotoxins, interferons, new cytokines, and chemokines, Cytokine provides comprehensive coverage of cytokines and their mechanisms of actions, 12 times a year by publishing original high quality refereed scientific papers from prominent investigators in both the academic and industrial sectors.
We will publish 3 major types of manuscripts:
1) Original manuscripts describing research results.
2) Basic and clinical reviews describing cytokine actions and regulation.
3) Short commentaries/perspectives on recently published aspects of cytokines, pathogenesis and clinical results.