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白细胞介素-6 水平与 2019 年冠状病毒病(COVID-19)患者的发病率和死亡率的关系。

Association of Interleukin-6 Levels with Morbidity and Mortality in Patients with Coronavirus Disease 2019 (COVID-19).

机构信息

Department of Cardiology, Renmin Hospital of Wuhan University, People's Republic of China.

出版信息

Jpn J Infect Dis. 2021 Jul 21;74(4):293-298. doi: 10.7883/yoken.JJID.2020.463. Epub 2020 Nov 30.

Abstract

The prognostic value of interleukin-6 (IL-6) in coronavirus disease 2019 (COVID-19) needs to be clarified. In this retrospective study, COVID-19 patients treated at Renmin Hospital of Wuhan University from January 7 to February 8, 2020 with measurements of serum IL-6 levels within 1 week after admission were included. Data regarding demographics, clinical characteristics, laboratory tests, complications, and outcomes were collected and analyzed. Sixty-six patients diagnosed with COVID-19 were included in this study (31 patients were females). They were divided into a normal group (serum IL-6 <10 pg/mL, n = 35) and an abnormal group (serum IL-6 <10 pg/mL, n = 31). Compared with the normal group, the incidence of critical cases (P <0.001), acute respiratory distress syndrome (ARDS) (P = 0.001), acute cardiac injury (P = 0.002), cardiac insufficiency (P = 0.039), mechanical ventilation rate (P = 0.002), and mortality (P = 0.021) was significantly increased in the abnormal group. Serum IL-6 concentration was an independent predictor of fatal outcome (P = 0.04). The optimal cutoff value of serum IL-6 concentration for predicting fatal outcomes was 26.09 pg/mL (P <0.001). In COVID-19, elevated serum IL-6 levels were associated with critical illness, use of mechanical ventilation, and complications, including heart injury and ARDS, and could predict a fatal outcome. Early detection of serum IL-6 levels after admission should be necessary in COVID-19 patients.

摘要

白细胞介素-6(IL-6)在 2019 年冠状病毒病(COVID-19)中的预后价值尚需阐明。在这项回顾性研究中,纳入了 2020 年 1 月 7 日至 2 月 8 日期间在武汉大学人民医院接受治疗的 COVID-19 患者,这些患者在入院后 1 周内测量了血清 IL-6 水平。收集并分析了有关人口统计学、临床特征、实验室检查、并发症和结局的数据。本研究共纳入 66 例确诊为 COVID-19 的患者(31 例为女性)。他们被分为正常组(血清 IL-6<10pg/mL,n=35)和异常组(血清 IL-6<10pg/mL,n=31)。与正常组相比,异常组危急病例(P<0.001)、急性呼吸窘迫综合征(ARDS)(P=0.001)、急性心脏损伤(P=0.002)、心功能不全(P=0.039)、机械通气率(P=0.002)和死亡率(P=0.021)的发生率明显更高。血清 IL-6 浓度是死亡结局的独立预测因子(P=0.04)。预测死亡结局的血清 IL-6 浓度最佳截断值为 26.09pg/mL(P<0.001)。在 COVID-19 中,血清 IL-6 水平升高与重症、机械通气以及包括心脏损伤和 ARDS 在内的并发症相关,并可预测死亡结局。COVID-19 患者入院后应早期检测血清 IL-6 水平。

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