Tamayo-Velasco Álvaro, Martínez-Paz Pedro, Peñarrubia-Ponce María Jesús, de la Fuente Ignacio, Pérez-González Sonia, Fernández Itziar, Dueñas Carlos, Gómez-Sánchez Esther, Lorenzo-López Mario, Gómez-Pesquera Estefanía, Heredia-Rodríguez María, Carnicero-Frutos Irene, Muñoz-Moreno María Fe, Bernardo David, Álvarez Francisco Javier, Tamayo Eduardo, Gonzalo-Benito Hugo
Department of Hematology, University Clinical Hospital, 47003 Valladolid, Spain.
Department of Surgery, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain.
J Clin Med. 2021 May 8;10(9):2017. doi: 10.3390/jcm10092017.
Pneumonia is the leading cause of hospital admission and mortality in coronavirus disease 2019 (COVID-19). We aimed to identify the cytokines responsible for lung damage and mortality. We prospectively recruited 108 COVID-19 patients between March and April 2020 and divided them into four groups according to the severity of respiratory symptoms. Twenty-eight healthy volunteers were used for normalization of the results. Multiple cytokines showed statistically significant differences between mild and critical patients. High HGF levels were associated with the critical group (OR = 3.51; < 0.001; 95%CI = 1.95-6.33). Moreover, high IL-1α (OR = 1.36; = 0.01; 95%CI = 1.07-1.73) and low IL-27 (OR = 0.58; < 0.005; 95%CI = 0.39-0.85) greatly increased the risk of ending up in the severe group. This model was especially sensitive in order to predict critical status (AUC = 0.794; specificity = 69.74%; sensitivity = 81.25%). Furthermore, high levels of HGF and IL-1α showed significant results in the survival analysis ( = 0.033 and = 0.011, respectively). HGF, IL-1α, and IL 27 at hospital admission were strongly associated with severe/critical COVID-19 patients and therefore are excellent predictors of bad prognosis. HGF and IL-1α were also mortality biomarkers.
肺炎是2019冠状病毒病（COVID-19）患者住院和死亡的主要原因。我们旨在确定导致肺损伤和死亡的细胞因子。2020年3月至4月，我们前瞻性招募了108例COVID-19患者，并根据呼吸道症状的严重程度将他们分为四组。28名健康志愿者用于结果的标准化。轻度和重症患者之间多种细胞因子存在统计学显著差异。高HGF水平与重症组相关（OR = 3.51；<0.001；95%CI = 1.95 - 6.33）。此外，高IL-1α（OR = 1.36；= 0.01；95%CI = 1.07 - 1.73）和低IL-27（OR = 0.58；<0.005；95%CI = 0.39 - 0.85）大大增加了最终进入重症组的风险。该模型在预测重症状态方面特别敏感（AUC = 0.794；特异性 = 69.74%；敏感性 = 81.25%）。此外，高HGF和IL-1α水平在生存分析中显示出显著结果（分别为 = 0.033和 = 0.011）。入院时的HGF、IL-1α和IL-27与重症/危重症COVID-19患者密切相关，因此是不良预后的优秀预测指标。HGF和IL-1α也是死亡生物标志物。
