Oley Mendy Hatibie, Oley Maximillian Christian, Kepel Billy Johnson, Tjandra Djony E, Langi Fima Lanra Fredrik G, Aling Deanette Michelle R, Joicetine Wagiu Angelica Maurene, Faruk Muhammad
Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia.
Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia.
Ann Med Surg (Lond). 2021 Mar;63:102171. doi: 10.1016/j.amsu.2021.02.017. Epub 2021 Feb 10.
Viral infection can compound the severity of pre-existing inflammation caused by underlying diseases. For those with a chronic, immune-related condition such as diabetic foot ulcers (DFUs), the coronavirus disease (COVID-19) serves to exacerbate the inflammatory burden. Serum levels of intracellular adhesion molecule-1 (ICAM-1), a primary mediator of cell adhesion express in the inflammatory process, are often used to indicate the gravity of all inflammatory conditions. Therefore, the purpose of this study was to investigate serum ICAM-1 levels before and after debridement in patients with DFUs who were also diagnosed as COVID-19 positive compared with those who were COVID-19 negative.
20 patients with DFUs were screened for COVID-19 and then divided into COVID-19 positive and negative groups according to the results. Before debridement, chest x-rays and blood analysis, including ICAM-1 serum levels, were performed in both groups. Only ICAM-1 serum levels were measured after debridement.
Of the 20 patients included in this study, 55% were male (n = 11) and 45% were female (n = 9). The mean age was 52.9 ± 1.9 years. ICAM-1 levels in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group (median 317.2 vs 149.2, respectively; p < 0.001). Serum levels of ICAM-1 reduced significantly in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group after debridement (median 312.5 vs 130.3; p < 0.001).
ICAM-1 serum levels represent an additional, initial screening marker for COVID-19.
病毒感染会加重潜在疾病引发的既有炎症的严重程度。对于患有慢性免疫相关疾病（如糖尿病足溃疡，DFU）的患者，冠状病毒病（COVID-19）会加剧炎症负担。细胞间黏附分子-1（ICAM-1）是炎症过程中细胞黏附的主要介质，其血清水平常被用于指示所有炎症状态的严重程度。因此，本研究的目的是调查确诊为COVID-19阳性的DFU患者与COVID-19阴性患者清创前后的血清ICAM-1水平。
对20例DFU患者进行COVID-19筛查，然后根据结果分为COVID-19阳性组和阴性组。两组在清创前均进行胸部X光检查和血液分析，包括ICAM-1血清水平检测。清创后仅检测ICAM-1血清水平。
本研究纳入的20例患者中，55%为男性（n = 11），45%为女性（n = 9）。平均年龄为52.9±1.9岁。COVID-19阳性组DFU患者的ICAM-1水平显著高于COVID-19阴性组（中位数分别为317.2和149.2；p < 0.001）。COVID-19阳性组DFU患者清创后的血清ICAM-1水平显著高于COVID-19阴性组（中位数为312.5和130.3；p < 0.001）。
ICAM-1血清水平是COVID-19的另一种初始筛查标志物。
