Cytokine prediction of mortality in COVID19 patients
Cytokine prediction of mortality in COVID19 patients
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DOI：
10.1016/j.cyto.2020.155190
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发表时间：
2020-10-01
期刊：
影响因子：
3.8
通讯作者：
Achiron, Anat
中科院分区：
文献类型：
--
作者：
Mandel, Mathilda;Harari, Gil;Achiron, Anat
2019年冠状病毒病（COVID 19）是一种危及生命的感染，其进展和结局不确定。评估病情恶化患者的疾病严重程度对于做出与支持性机械通气和积极治疗相关的决策非常重要。这是一项前瞻性、非随机研究，纳入了诊断为COVID 19的住院患者。在住院期间评估促炎细胞因子，并根据血清白细胞介素1 β水平计算30天死亡率的预测模式（IL 1 β）、白细胞介素6（IL 6）、白细胞介素8（IL 8）和肿瘤坏死因子α分析了71名COVID 19患者的数据，平均年龄62岁，SD 13.8，50名男性，21名女性。12名（16.9%）患者在首次COVID 19鼻咽检测阳性后7-39天内死亡。IL-6和TNF-α水平在未存活的患者中显著较高。以163.4 pg/ml为界值，IL 6预测死亡率的敏感性为91.7%，特异性为57.6%，IL 6表达对预测COVID 19住院患者30 d死亡率具有重要意义，因此，IL 6表达可为治疗决策提供帮助。
Coronavirus disease 2019 (COVID19) is a life-threatening infection with uncertain progression and outcome. Assessing the severity of the disease for worsening patients is of importance in making decisions related to supportive mechanical ventilation and aggressive treatments. This was a prospective, non-randomized study that included hospitalized patients diagnosed with COVID19. Pro-inflammatory cytokines were assessed during hospitalization, and we calculated a prediction paradigm for 30-day mortality based on the serum levels of interleukin1 beta (IL1 beta), interleukin6 (IL6), interleukin8 (IL8), and tumor necrosis factor alpha (TNF alpha) measured by next-generation ELISA.Data of 71 COVID19 patients, mean age 62 years, SD13.8, 50 males, 21 females, were analyzed. Twelve (16.9%) patients died within 7-39 days of their first COVID19 positive nasopharyngeal test. Levels of IL6 and TNF alpha were significantly higher in patients that did not survive. IL6 predicted mortality at the cut-off value of 163.4 pg/ml, with a sensitivity of 91.7% and specificity of 57.6%.Our findings demonstrate that IL6 expression is significant for the prediction of 30-day mortality in hospitalized COVID19 patients and, therefore, may assist in treatment decisions.