Serum IL-6 and procalcitonin are two promising novel biomarkers for evaluating the severity of COVID-19 patients

Tang, Jinsong; Lin, Jingtao; Zhang, Erying; Zhong, Mengru; Luo, Yong; Fu, Yong; Yang, Yewei

doi:10.1097/md.0000000000026131

Cited by 21 publications

(23 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings revealed that elevated procalcitonin was most strongly associated with both mortality and ICU acceptance, thereby contributing to the growing body of evidence for the utility of procalcitonin in the context of COVID-19 infection [14,15]. Calcitonin is normally expressed in neuroendocrine cells, but its precursor, procalcitonin (PCT), has been identified as a unique biomarker specific for bacterial sepsis [16].…”

Section: Discussionmentioning

confidence: 56%

“…One meta-analysis demonstrated that elevated procalcitonin levels were linked with a 5-fold increased risk of severe COVID-19 infection [22] while another found that elevated procalcitonin, elevated D-dimer, and thrombocytopenia were all associated with severe infection [23]. Similarly, a study from China revealed correlations of IL-6 and procalcitonin levels with COVID-19 severity [14], namely that those with the highest levels of these two biomarkers exhibited significantly increased disease severity. Moreover, a meta-analysis of 25 studies with 5350 patients found that elevated procalcitonin levels were associated with an increased composite poor outcome [RR 3.92 (2.42, 6.35), p < 0.001; I 2 : 85%].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: This study aimed to identify demographic and clinical factors at the time of critical care consultation associated with mortality or intensive care unit acceptance in a predominantly Afro-Caribbean population during the first wave of the COVID19 pandemic. Materials and Methods: This retrospective, single-center observational cohort study included 271 COVID19 patients who received a critical care consult between March 11 and April 30, 2020 during the first wave of the COVID19 pandemic at State University of New York Downstate Health Sciences University. Results: Of the 271 patients with critical care consults, 33% survived and 67% expired. At the bivariate level, age, blood urea nitrogen, and blood neutrophil percentage were significantly associated with mortality (mean age: survivors, 61.62 ± 1.50 vs. non-survivors, 68.98 ± 0.85, p < 0.001). There was also a significant association between neutrophil% and mortality in the univariate logistic regression model (quartile 4 vs. quartile 1: odd ratio 2.73, 95% confidence interval (1.28–5.82), p trend = 0.044). In the multivariate analyses, increasing levels of procalcitonin and C-reactive protein were significantly associated with mortality, adjusting for age, sex, and race/ethnicity (for procalcitonin quartile 4 vs. quartile 1: odds ratio 5.65, 95% confidence interval (2.14–14.9), p trend < 0.001). In contrast, higher platelet levels correlated with significantly decreased odds of mortality (quartile 4 vs. quartile 1, odds ratio 0.47, 95% CI (0.22–0.998), p trend = 0.010). Of these factors, only elevated procalcitonin levels were associated with intensive care unit acceptance. Conclusions: Procalcitonin showed the greatest magnitude of association with both death and likelihood of intensive care unit acceptance at the bivariate level. Our data suggests that procalcitonin reflects pneumonia severity during COVID-19 infection. Thus, it may help the intensivist identify those COVID19 patients who require intensive care unit level care.

show abstract

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The mean IL-6 levels were recorded to be significantly higher in patients with severe COVID-19 compared with non-severe COVID-19 patients [15,16,[88][89][90][91][92][93][94]. Additionally, IL-6 was also reported as an independent predictor of ICU admission [95].…”

Section: Discussionmentioning

confidence: 92%

“…IL-6 increases the leukocyte migration to areas of inflammation, increases the division of B cells that produce antibodies, and plays a role in Th17 differentiation in T cells [80] (pp. [85][86][87]92). IL-6 activates the intracellular cascade of Jak/STAT (Janus kinases/signal transducers and activators of transcription) [87].…”

Section: Discussionmentioning

confidence: 99%

The Association between TNF-α, IL-6, and Vitamin D Levels and COVID-19 Severity and Mortality: A Systematic Review and Meta-Analysis

2022

View full text Add to dashboard Cite

Background: An increasing number of scientific journals have proposed a connection between tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and the severity of COVID-19. Vitamin D has been discussed as a potential therapy for COVID-19 due to its immunomodulatory effects. This meta-analysis aims to determine the relationship, if any, between TNF-α, IL-6, vitamin D, and COVID-19 severity and mortality. Methods: The design of the study is a systematic review and meta-analysis. A literature search is performed using PubMed, Cochrane, ProQuest, and Google Scholar. Results: TNF-α insignificantly increases the risk of COVID-19 severity (adjusted odds ratio (aOR) = 1.0304; 95% CI 0.8178–1.2983; p = 0.80) but significantly increases the risk of COVID-19 mortality (crude hazard ratio (HR) = 1.0640; 95% CI 1.0259–1.1036; p = 0.0009). IL-6 significantly increases the risk of COVID-19 severity (aOR = 1.0284; 95% CI 1.0130–1.0441; p = 0.0003) and mortality (aOR = 1.0076; 95% CI 1.0004–1.0148; p = 0.04; adjusted hazard ratio (aHR) = 1.0036; 95% CI 1.0010–1.0061; p = 0.006). There is a statistically insignificant difference of the mean vitamin D levels between patients with severe COVID-19 and non-severe COVID-19 (mean difference (MD) = −5.0232; 95% CI 11.6832–1.6368; p = 0.14). A vitamin D deficiency insignificantly increases the risk of mortality of COVID-19 patients (aOR = 1.3827; 95% CI 0.7103–2.6916; p = 0.34). Conclusion: IL-6 is an independent prognostic factor towards COVID-19 severity and mortality.

show abstract

“…Pro-inflammatory cytokines such as interleukin-1 (IL-1), IL-6, IL-8, and tumor necrosis factor alpha (TNF-a) have been found to be elevated in the sera of severely and critically ill COVID-19 patients, anti-inflammatory cytokines such as IL-10 have also been found in the sera of COVID-19 patients (13)(14)(15). Plasma IP-10, MCP-3 sTIM-3, HGF, IL-1a, IL-27, and PCT cytokines have also been reported to be related to the severity of the disease (16)(17)(18)(19). The profile of cytokine gene expression by cDNA arrays and protein arrays are widely used in different infectious diseases to identify biomarkers (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Profiling of Inflammatory Factors Revealed That Growth Differentiation Factor-15 Is an Indicator of Disease Severity in COVID-19 Patients

et al. 2021

View full text Add to dashboard Cite

To systematically explore potential biomarkers which can predict disease severity in COVID-19 patients and prevent the occurrence or development of severe COVID-19, the levels of 440 factors were analyzed in patients categorized according to COVID-19 disease severity; including asymptomatic, mild, moderate, severe, convalescent and healthy control groups. Factor candidates were validated by ELISA and functional relevance was uncovered by bioinformatics analysis. To identify potential biomarkers of occurrence or development of COVID-19, patient sera from three different severity groups (moderate, severe, and critical) at three time points (admission, remission, and discharge) and the expression levels of candidate biomarkers were measured. Eleven differential factors associated with disease severity were pinpointed from 440 factors across 111 patients of differing disease severity. The dynamic changes of GDF15 reflect the progression of the disease, while the other differential factors include TRAIL R1, IGFBP-1, IGFBP-4, VCAM-1, sFRP-3, FABP2, Transferrin, GDF15, IL-1F7, IL-5Rα, and CD200. Elevation of white blood cell count, neutrophil count, neutrophil-lymphocyte ratio (NLR), Alanine aminotransferase and Aspartate aminotransferase, low lymphocyte and eosinophil counts in the severe group were associated with the severity of COVID-19. GDF15 levels were observed to be associated with the severity of COVID-19 and the dynamic change of GDF15 levels was closely associated with the COVID-19 disease progression. Therefore, GDF15 might serve as an indicator of disease severity in COVID-19 patients.

show abstract

Serum IL-6 and procalcitonin are two promising novel biomarkers for evaluating the severity of COVID-19 patients

Cited by 21 publications

References 18 publications

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

The Association between TNF-α, IL-6, and Vitamin D Levels and COVID-19 Severity and Mortality: A Systematic Review and Meta-Analysis

Comprehensive Profiling of Inflammatory Factors Revealed That Growth Differentiation Factor-15 Is an Indicator of Disease Severity in COVID-19 Patients

Contact Info

Product

Resources

About