Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19

Li, Yan; Yang, Shuang; Ding, Pingyu; Zhu, Hongming; Li, Bangyi; Yang, Xiaojiao; Sun, Xuelian; Zhang, Mei

doi:10.12998/wjcc.v8.i20.4726

Cited by 26 publications

(39 citation statements)

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“…In a study of a mixed ICU, Dyanne et al verified the prognosis value of CysC in the illness severity in critically ill patients [46]. The predictive value of Cys C in the prognosis of COVID-19 patients has also been reported by Yan Li et al [45] and Dan Chen et al [38] separately. It seemed interesting that eGFRcysc is a poor predictive factor while CysC itself could be a good predictor of mortality in critically ill patients with COVID-19.…”

Section: Discussionmentioning

confidence: 81%

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Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

et al. 2021

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Background: The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study. Methods: This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored. Results: A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m 2 ) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m 2 ) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m 2 while 25% showed eGFRcr < 60 ml/min/1.73 m 2 (v 2 ¼ 10.133, p ¼ 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-a) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m 2 ) was associated with death (HR ¼ 1.939, 95%CI 1.078-3.489, p ¼ 0.027). Conclusions: The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.

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Section: Discussionmentioning

confidence: 81%

“…Evidence suggested that renal impairments were associated with worse prognosis [41][42][43]. Recently, the relationship between kidney injury and mortality in COVID-19 has also been reported [8,9,44,45]. To a certain extent, the prognosis values of eGFRcr and eGFRcysc could indirectly reflect the ability of renal function assessment.…”

Section: Discussionmentioning

confidence: 99%

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

et al. 2021

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“…Two studies were conducted in Turkey [ 34 , 58 ], 1 in the USA [ 57 ], 1 in Korea [ 52 ], and the remaining 51 in China [ 14 , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [53] , [54] , [55] , [56] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] ]. Three studies were prospective [ 42 , 53 , 68 ], 47 retrospective [ [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ...…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were prospective [ 42 , 53 , 68 ], 47 retrospective [ [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [43] , [44] , [45] , [46] , [47] , [48] , [50] , [51] , [52] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , 67 , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , 87 ], whereas the remaining 5 did not report information regarding the study design [ 14 , 49 , 66 , 71 , 86 ]. Clinical endpoints included disease severity based on current clinical guidelines in 21 studies [ 38 , 43 , 45 , [48] , [49] , [50] , [51] , [52] , 54 ...…”

Section: Resultsmentioning

confidence: 99%

“…We further sought to identify additional, more homogeneous, study sub-groups according to endpoint reported, study design (retrospective or prospective), country, and assay type (measurement of CK-MB on the basis of activity or mass). In particular, a sub-group of 13 retrospective studies conducted in China [ 40 , 44 , 47 , 55 , 62 , 69 , 73 , [75] , [76] , [77] , 81 , 83 , 87 ] assessed survival and measured CK-MB using an assay based on activity evaluation. Funnel plot analysis showed that 3 of these studies were located outside of the plot ( Figure 8 A) [ 62 , 77 , 83 ].…”

Section: Resultsmentioning

confidence: 99%

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Serum CK-MB, COVID-19 severity and mortality: An updated systematic review and meta-analysis with meta-regression

Zinellu

Sotgia

Fois

et al. 2021

Advances in Medical Sciences

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Objectives We conducted a systematic review and meta-analysis with meta-regression of creatine kinase-MB (CK-MB), a biomarker of myocardial injury, in COVID-19 patients. Methods We searched PubMed, Web of Science and Scopus, for studies published between January 2020 and January 2021 that reported CK-MB, COVID-19 severity and mortality (PROSPERO registration number: CRD42021239657). Results Fifty-five studies in 11,791 COVID-19 patients were included in the meta-analysis. The pooled results showed that CK-MB concentrations were significantly higher in patients with high disease severity or non-survivor status than patients with low severity or survivor status (standardized mean difference, SMD, 0.81, 95% CI 0.61 to 1.01, p<0.001). The rate of patients with CK-MB values above the normal range was also significantly higher in the former than the latter (60/350 vs 98/1,780; RR=2.84, 95%CI 1.89 to 4.27, p<0.001; I 2 =19.9, p=0.254). Extreme between-study heterogeneity was observed (I 2 =93.4%, p<0.001). Sensitivity analysis, performed by sequentially removing each study and re-assessing the pooled estimates, showed that the magnitude and direction of the effect size was not modified (effect size range, 0.77 to 0.84). Begg's (p=0.50) and Egger's (p=0.86) t-tests did not show publication bias. In meta-regression analysis, the SMD was significantly and positively associated with the white blood count, aspartate aminotransferase, myoglobin, troponin, brain natriuretic peptide, lactate dehydrogenase, and D-dimer. Conclusions Higher CK-MB concentrations were significantly associated with severe disease and mortality in COVID-19 patients. This biomarker of myocardial injury might be useful for risk stratification in this group.

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Exploratory analysis of interleukin‐38 in hospitalized COVID‐19 patients

Graaf

Teufel

Nooijer

et al. 2022

Immunity Inflam & Disease

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Introduction A major contributor to coronavirus disease 2019 (COVID‐19) progression and severity is a dysregulated innate and adaptive immune response. Interleukin‐38 (IL−38) is an IL‐1 family member with broad anti‐inflammatory properties, but thus far little is known about its role in viral infections. Recent studies have shown inconsistent results, as one study finding an increase in circulating IL‐38 in COVID‐19 patients in comparison to healthy controls, whereas two other studies report no differences in IL‐38 concentrations. Methods Here, we present an exploratory, retrospective cohort study of circulating IL‐38 concentrations in hospitalized COVID‐19 patients admitted to two Dutch hospitals (discovery n = 148 and validation n = 184) and age‐ and sex‐matched healthy subjects. Plasma IL‐38 concentrations were measured by enzyme‐linked immunosorbent assay, disease‐related proteins by proximity extension assay, and clinical data were retrieved from hospital records. Results IL‐38 concentrations were stable during hospitalization and similar to those of healthy control subjects. IL‐38 was not associated with rates of intensive care unit admission or mortality. Only in men in the discovery cohort, IL‐38 concentrations were positively correlated with hospitalization duration. A positive correlation between IL‐38 and the inflammatory biomarker d‐dimer was observed in men of the validation cohort. In women of the validation cohort, IL‐38 concentrations correlated negatively with thrombocyte numbers. Furthermore, plasma IL‐38 concentrations in the validation cohort correlated positively with TNF, TNFRSF9, IL‐10Ra, neurotrophil 3, polymeric immunoglobulin receptor, CHL1, CD244, superoxide dismutase 2, and fatty acid binding protein 2, and negatively with SERPINA12 and cartilage oligomeric matrix protein. Conclusions These data indicate that IL‐38 is not associated with disease outcomes in hospitalized COVID‐19 patients. However, moderate correlations between IL‐38 concentrations and biomarkers of disease were identified in one of two cohorts. While we demonstrate that IL‐38 concentrations are not indicative of COVID‐19 severity, its anti‐inflammatory effects may reduce COVID‐19 severity and should be experimentally investigated.

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Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19

Cited by 26 publications

References 24 publications

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

Serum CK-MB, COVID-19 severity and mortality: An updated systematic review and meta-analysis with meta-regression

Exploratory analysis of interleukin‐38 in hospitalized COVID‐19 patients

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