Serum chemokine <scp>CC</scp> ‐motif ligand 17 is a predictive marker of severe <scp>COVID</scp> ‐19 in haemodialysis patients: A retrospective observational study
Serum chemokine <scp>CC</scp> ‐motif ligand 17 is a predictive marker of severe <scp>COVID</scp> ‐19 in haemodialysis patients: A retrospective observational study
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血清趋化因子 <scp>CC</scp> ‐基序配体 17 是血液透析患者中严重 <scp>COVID</scp> ‐19 的预测标志物：一项回顾性观察研究
DOI：
10.1111/nep.14151
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发表时间：
2023
期刊：
影响因子：
2.5
通讯作者：
Wakai Sachiko
中科院分区：
文献类型：
--
作者：
Beppu Hiroko;Fukuda Tatsuya;Otsubo Naoya;Kawanishi Tomoko;Ogawa Toshie;Abe Yasutomo;Endo Mariko;Hanawa Tomohide;Sugita Chise;Kikkawa Yoshiaki;Hatakeyama Shuji;Yamada Tetsuya;Wakai Sachiko
背景维持性血液透析(HD)患者患2019年严重冠状病毒病的风险更高(新冠肺炎)。由于可提供新冠肺炎和HD住院治疗的设施有限，因此确定哪些HD患者是重度新冠肺炎的高危人群非常重要。对于轻中度新冠肺炎患者，趋化因子CC基序配体17(CCL17)被报道为重度新冠肺炎的预测标记物；然而，CCL17在HD患者中的有效性尚不清楚。方法这项回顾性观察研究纳入107例住院期间患有轻中度新冠肺炎的HD患者(平均年龄70.1 ± 15.1 ；男性71.0%)。结果32例患者在住院期间发生严重新冠肺炎，入院时采集的血清CCL17预测严重新冠肺炎的曲线下面积(0.818)高于乳酸脱氢酶和C反应蛋白等其他指标，CCL17的最佳临界值为150.5 pg/mL。多因素Logistic回归分析显示，即使在调整协变量后，CCL17(>150.5 pg/ml)仍与重度新冠肺炎显著相关(优势比0.063；95%可信区间0.017-0.227；p<； .001)。在由接种状况、白蛋白、血尿素氮、C反应蛋白和乳酸脱氢酶组成的模型中加入CCL17后，使用净重分类(1.16，95%CI：0.82~1.50，p<； .001)和综合判别度(0.18，95%CI：0.09~0.26，p<； .001)显著改善重度新冠肺炎的分类性能。
BackgroundMaintenance haemodialysis (HD) patients are at higher risk for severe coronavirus disease 2019 (COVID‐19). Because of a limited number of facilities that can provide inpatient treatment for COVID‐19 and HD, it is important to identify HD patients who are at high risk for severe COVID‐19. For mild to moderate COVID‐19 patients, chemokine CC‐motif ligand 17 (CCL17) was reported to be a predictive marker for severe COVID‐19; however, the validity of CCL17 among HD patients is unknown.MethodsThis retrospective observational study enrolled 107 HD patients with mild or moderate COVID‐19 at hospitalization (mean age 70.1 ± 15.1 years; 71.0% male). Receiver operating characteristic and logistic regression analyses were used to examine the predictive validity of indices for severe COVID‐19.ResultsDuring hospitalization, 32 patients developed severe COVID‐19. Serum CCL17 collected at admission exhibited a higher area under the curve value (0.818) compared with that of other indicators including lactate dehydrogenase and C‐reactive protein for the prediction of severe COVID‐19. The optimal cut‐off value for CCL17 was 150.5 pg/mL. A multi‐variate logistic analysis revealed that CCL17 (above 150.5 pg/mL) was significantly associated with severe COVID‐19 (Odds ratio, 0.063; 95% Confidence interval [CI], 0.017–0.227;p< .001) even after adjustment for covariates. The addition of the CCL17 to a model consisting of vaccination status, albumin, blood urea nitrogen, C‐reacting protein and lactate dehydrogenase significantly improved classification performance for severe COVID‐19 using the net reclassification (1.16, 95% CI: 0.82–1.50,p< .001) and integrated discrimination (0.18, 95% CI: 0.09–0.26,p< .001) improvement.ConclusionCCL17 levels in HD patients with mild or moderate COVID‐19 predict risk of developing severe COVID‐19.