Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey.
Depertmant of Infection Diseases and Clinical Microbiology, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey.
Lung. 2020 Oct;198(5):777-784. doi: 10.1007/s00408-020-00393-8. Epub 2020 Sep 12.
SARS-CoV-2 (COVID-19) has infected more than 7 million people worldwide in the short time since it emerged in Wuhan, China in December 2019. The aim of this study was to investigate the relationship between serum interleukin 6 (IL-6) and surfactant protein D (SP-D) levels and the clinical course and prognosis of COVID-19.
The study included a total of 108 individuals: 88 patients who were diagnosed with COVID-19 by real-time PCR of nasopharyngeal swab samples and admitted to the Atatürk University Pulmonary Diseases and the Erzurum City Hospital Infectious Diseases department between March 24 and April 15, and 20 asymptomatic healthcare workers who had negative real-time PCR results during routine COVID-19 screening in our hospital.
Patients who developed macrophage activation syndrome had significantly higher IL-6 and SP-D levels at the time of admission and on day 5 of treatment compared to the other patients (IL-6: p = 0.001 for both; SP-D: p = 0.02, p = 0.04). Patients who developed acute respiratory distress syndrome had significantly higher IL-6 and SP-D levels at both time points compared to those who did not (p = 0.001 for all). Both parameters at the time of admission were also significantly higher among nonsurvivors compared to survivors (IL-6: p = 0.001, SP-D: p = 0.03).
In addition to IL-6, which has an important role in predicting course and planning treatment in COVID-19, SP-D may be a novel pneumoprotein that can be used in the clinical course, follow-up, and possibly in future treatments.
自 2019 年 12 月中国武汉出现以来，SARS-CoV-2（COVID-19）在短时间内在全球范围内感染了超过 700 万人。本研究旨在探讨血清白细胞介素 6（IL-6）和表面活性蛋白 D（SP-D）水平与 COVID-19 临床病程和预后的关系。
该研究共纳入 108 人：88 例经鼻咽拭子实时 PCR 确诊为 COVID-19 的患者，于 2020 年 3 月 24 日至 4 月 15 日入住阿塔图尔克大学肺病科和埃尔祖鲁姆市医院传染病科；20 例无症状医护人员在我院常规 COVID-19 筛查中实时 PCR 结果为阴性。
入院时和治疗第 5 天发生巨噬细胞活化综合征的患者 IL-6 和 SP-D 水平明显高于其他患者（IL-6：均为 p=0.001；SP-D：p=0.02，p=0.04）。发生急性呼吸窘迫综合征的患者在两个时间点的 IL-6 和 SP-D 水平均明显高于未发生急性呼吸窘迫综合征的患者（均为 p=0.001）。入院时的两个参数在幸存者与非幸存者之间也存在显著差异（IL-6：p=0.001，SP-D：p=0.03）。
除了在 COVID-19 中预测病程和规划治疗中起重要作用的 IL-6 外，SP-D 可能是一种新型的肺蛋白，可用于临床病程、随访，甚至可能用于未来的治疗。
