Interleukin-21: a potential biomarker for diagnosis and predicting prognosis in COVID-19 patients
Interleukin-21: a potential biomarker for diagnosis and predicting prognosis in COVID-19 patients
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DOI：
10.3906/sag-2102-24
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发表时间：
2021-01-01
影响因子：
2.3
通讯作者：
Karadag, Mehmet
中科院分区：
文献类型：
--
作者：
Acet Ozturk, Nilufer Aylin;Ursavas, Ahmet;Karadag, Mehmet
背景/目标：COVID-19 患者的疾病严重程度多种多样。一些生物标志物被评估为严重疾病进展的预测因子。 IL-21 是常见伽玛链细胞因子家族的成员，在抗病毒免疫的编程和维持过程中产生一些特定的作用。我们的目的是评估 IL-21 作为 COVID-19 住院患者诊断和结果预测的生物标志物。材料和方法：本比较研究连续纳入三级甲等医院收治的初步诊断为 COVID-19 和除 COVID-19 以外的肺炎的患者。结果：研究人群包括 51 名 COVID-19 患者和 11 名非 COVID-19 肺炎患者。与非 COVID-19 肺炎患者相比，COVID-19 患者的血清 IL-21 浓度显着较高，血清 CRP 浓度显着较低。在 COVID-19 患者中，10 名患者出现放射学和临床进展。临床恶化的患者淋巴细胞计数和血红蛋白较低。除此之外，病情恶化的患者尿素、LDH 水平较高，IL-6 和 IL-21 浓度也较高。 IL-21 的临界值 106 ng/L 对于区分临床恶化的患者具有 80.0% 的敏感性和 60.9% 的特异性。为定义疾病进展的危险因素而进行的多变量分析将 IL-6 和 IL-21 确定为独立的预测因子。血清 IL-6 浓度 >_ 3.2 pg/mL 的优势比为 8.07 (95% CI: 1.3747.50, p = 0.04)，血清 IL-21 浓度 >_ 106 ng/L 的优势比为 6.24 (95% CI: 1.04 - 37.3, p = 0.02)。结论：我们确定了 COVID-19 和非 COVID-19 肺炎患者之间血清 IL-21 的特异性差异。血清 IL-21 测量对 COVID-19 患者的疾病进展具有良好的预测价值。入院时血清IL-6和IL-21水平升高是临床恶化的独立危险因素。
Background/aim: COVID-19 patients have a wide spectrum of disease severity. Several biomarkers were evaluated as predictors for progression towards severe disease. IL-21 is a member of common gamma-chain cytokine family and creates some specific effects during programming and maintenance of antiviral immunity. We aimed to assess IL-21 as a biomarker for diagnosis and outcome prediction in patients hospitalized with COVID-19. Materials and methods: Patients with a preliminary diagnosis of COVID-19 and pneumonia other than COVID-19 admitted to a tertiary care hospital were included consecutively in this comparative study. Results: The study population consisted of 51 patients with COVID-19 and 11 patients with non-COVID-19 pneumonia. Serum IL-21 concentration was markedly higher, and serum CRP concentration was significantly lower in COVID-19 patients compared to nonCOVID-19 pneumonia patients. Within COVID-19 patients, 10 patients showed radiological and clinical progression. Patients with clinical worsening had lower lymphocyte count and haemoglobin. In addition to that, deteriorating patients had higher urea, LDH levels, and elevated concentration of both IL-6 and IL-21. The cut-off value of 106 ng/L for IL-21 has 80.0% sensitivity, %60.9 specificity for discriminating patients with clinical worsening. Multivariable analysis performed to define risk factors for disease progression identified IL-6 and IL-21 as independent predictors. Odds ratio for serum IL-6 concentrations >_ 3.2 pg/mL was 8.07 (95% CI: 1.3747.50, p = 0.04) and odds ratio for serum IL-21 concentrations >_ 106 ng/L was 6.24 (95% CI: 1.04 - 37.3, p = 0.02). Conclusion: We identified specific differences in serum IL-21 between COVID-19 and non-COVID-19 pneumonia patients. Serum IL-21 measurement has promising predictive value for disease progression in COVID-19 patients. High serum IL-6 and IL-21 levels obtained upon admission are independent risk factors for clinical worsening.