Increased inflammatory mediators levels are associated with clinical outcomes and prolonged illness in severe COVID-19 patients

Hao, Wendong; Liu, Meimei; Bai, C.; Liu, Xin; Shanfu, Niu; Chen, Xiushan

doi:10.1016/j.intimp.2023.110762

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…In a study, it was found that CX3CL1, D-dimer, procalcitonin, and Interleukin-6 could effectively predict mortality in patients with severe COVID-19 [38]. Moreover, only the circulating levels of CX3CL1 and D-dimer were significantly correlated with the duration of illness.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Ince,

Alkan Bilik,

Ince

2024

Diagnostics

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Introduction: Numerous studies suggest that alterations in blood parameters, such as changes in platelet, lymphocyte, hemoglobin, eosinophil, and basophil counts; increased neutrophil counts; and elevated neutrophil/lymphocyte and platelet/lymphocyte ratios, signal COVID-19 infection and predict worse outcomes. Leveraging these insights, our study seeks to create a predictive mortality model by assessing age and crucial laboratory markers. Materials and Methods: Patients were categorized into two groups based on their hospital outcomes: 130 survivors who recovered from their Intensive Care Unit (ICU) stay (Group 1) and 74 who died (Group 2). We then developed a predictive mortality model using patients’ age, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), procalcitonin levels, and ferritin lactate (FL) index results. Results: A total of 204 patients were included. Patients in Group 2 had a notably higher mean age compared to those in Group 1 (76 ± 11 vs. 66 ± 15 years) (p < 0.001). Using specific cut-off values, our analysis revealed varying effectiveness in predicting COVID-19 mortality: Those aged over 73 years showed 74% sensitivity and 60% specificity, with an area under the curve (AUC) of 0.701. Procalcitonin levels above 0.35 ng/mL balanced true-positive and -negative identifications well, achieving an AUC of 0.752. The FL index, with a threshold of 1228 mg/dL, had 68% sensitivity and 65% specificity with an AUC of 0.707. A PLR higher than 212 resulted in 48% sensitivity and 69% specificity, with an AUC of 0.582. An NLR higher than 5.8 resulted in 55% sensitivity and 63% specificity, with an AUC of 0.640, showcasing diverse predictive accuracies across parameters. The statistical analysis evaluated the effects of age (>73), procalcitonin levels (>0.35), FL > 1228, PLR > 212, and NLR > 5.8 on mortality variables using logistic regression. Ages over 73 significantly increased event odds by 2.1 times (p = 0.05), procalcitonin levels above 0.35 nearly quintupled the odds (OR = 5.6, p < 0.001), high FL index levels more than tripled the odds (OR = 3.5, p = 0.003), a PLR > 212 significantly increased event odds by 3.5 (p = 0.030), and an NLR > 5.8 significantly increased event odds by 1.6 (p = 0.043). Conclusions: Our study highlights significant predictors of mortality in COVID-19 ICU patients, including advanced age, elevated procalcitonin, FL index levels, the PLR, and the NLR.

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Section: Discussionmentioning

confidence: 99%

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Ince,

Alkan Bilik,

Ince

2024

Diagnostics

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“…This study enrolled 79 severely diseased patients with COVID-19 and 72 healthy individuals as a control group. Many articles about the increased level of IL-6 and its role as an important indicator of severe COVID-19 (14)(15)(16)(17)(18) led us to think about the correlation of this marker with DHEA-S, as several reports revealed the inverse correlation between these two parameters (19)(20)(21). Among current study patients, the gender distribution showed nearly equal involvement of both sexes, with a slight preference towards males, which goes with Zaher K. et al, 2023 (22) and Jian-Min J. et al, 2020 (23) who describe the gender distribution among severely affected patients.…”

Section: Discussionmentioning

confidence: 99%

The Correlation Between Interleukin -6 and Dehydroepiandrosterone Sulfate in Patients with Severe COVID-19

Alrifai,

Mohammed,

Jasem

2024

Al-Kindy Col. Med. J

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Background: Numerous studies have demonstrated that interleukin-6 (IL-6) and serum dehydroepiandrosterone sulfate levels are negatively correlated. Low DHEA-S levels may be associated with severe disease and clinically ailing patients in the context of infectious diseases. Individuals infected with Coronavirus disease who exhibit elevated levels of IL-6 may undergo a cytokine storm, which can result in severe manifestations and a dismal prognosis. Objectives: To examine the relationship between DHEA-S and Il-6 in patients exhibiting severe manifestations of COVID-19. Subjects and Methods: A case-control investigation with 79 patients, ranging in age from 36 to 74 years, who were admitted to the hospital due to severe COVID-19 disease. A control group of 72 ostensibly healthy individuals was also included in the study. Using the ELISA method, the concentrations of IL-6 and DHEA-S in the serum of both groups were determined. The statistical analyses involved the application of the Pearson correlation coefficient and the T-test. None of the authors present any conflicts of interest. Results: With a Pearson correlation coefficient (r) of -0.8349, the study revealed a highly significant negative correlation (P < 0.0001) between the mean IL-6 level (64.369 pg/ml ± 2.6237) and the mean DHEA-S level (1.2728 ng/ml ± 1.7005) in the study group. An exceptionally significant statistical disparity was also identified when IL-6 and DHEA-S levels were compared between the study and control groups. Conclusions: In severely infected COVID-19 patients inverse correlation between the levels of IL-6 and DHEA-S indicates that DHEA-S deficiency may play a role in cytokine storm formation for these patients.

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“…During COVID-19 infection, the levels of CX3CL1 in the serum inflammatory mediators were higher in critically ill patients than those in severe COVID-19 patients. Moreover, the levels of CX3CL1 were associated with the duration of illness in severe COVID-19 [118]. Patients with chronic obstructive pulmonary disease have systemic inflammatory dysregulation driven by several cytokines, including CX3CL1, which are involved in chemokine signaling pathways associated with the response to severe COVID-19 virus infection [91,119,120].…”

Section: Cx3cl1 and Its Receptor In Covid-19mentioning

confidence: 99%

Alterations in CX3CL1 Levels and Its Role in Viral Pathogenesis

Zhang,

Zhuang

et al. 2024

IJMS

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CX3CL1, also named fractalkine or neurotactin, is the only known member of the CX3C chemokine family that can chemoattract several immune cells. CX3CL1 exists in both membrane-anchored and soluble forms, with each mediating distinct biological activities. CX3CL1 signals are transmitted through its unique receptor, CX3CR1, primarily expressed in the microglia of the central nervous system (CNS). In the CNS, CX3CL1 acts as a regulator of microglia activation in response to brain disorders or inflammation. Recently, there has been a growing interest in the role of CX3CL1 in regulating cell adhesion, chemotaxis, and host immune response in viral infection. Here, we provide a comprehensive review of the changes and function of CX3CL1 in various viral infections, such as human immunodeficiency virus (HIV), SARS-CoV-2, influenza virus, and cytomegalovirus (CMV) infection, to highlight the emerging roles of CX3CL1 in viral infection and associated diseases.

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Increased inflammatory mediators levels are associated with clinical outcomes and prolonged illness in severe COVID-19 patients

Cited by 3 publications

References 30 publications

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

The Correlation Between Interleukin -6 and Dehydroepiandrosterone Sulfate in Patients with Severe COVID-19

Alterations in CX3CL1 Levels and Its Role in Viral Pathogenesis

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