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基于入院时性别特异性生物标志物预测感染 SARS-CoV-2 的患者发生呼吸衰竭的风险。

Predicting respiratory failure in patients infected by SARS-CoV-2 by admission sex-specific biomarkers.

机构信息

Centro di Riferimento per la Medicina di Genere, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.

Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (IRCCS), Via Portuense 292, Rome, Italy.

出版信息

Biol Sex Differ. 2021 Nov 22;12(1):63. doi: 10.1186/s13293-021-00407-x.

DOI:10.1186/s13293-021-00407-x
PMID:34809704
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8607227/
Abstract

BACKGROUND

Several biomarkers have been identified to predict the outcome of COVID-19 severity, but few data are available regarding sex differences in their predictive role. Aim of this study was to identify sex-specific biomarkers of severity and progression of acute respiratory distress syndrome (ARDS) in COVID-19.

METHODS

Plasma levels of sex hormones (testosterone and 17β-estradiol), sex-hormone dependent circulating molecules (ACE2 and Angiotensin1-7) and other known biomarkers for COVID-19 severity were measured in male and female COVID-19 patients at admission to hospital. The association of plasma biomarker levels with ARDS severity at admission and with the occurrence of respiratory deterioration during hospitalization was analysed in aggregated and sex disaggregated form.

RESULTS

Our data show that some biomarkers could be predictive both for males and female patients and others only for one sex. Angiotensin1-7 plasma levels and neutrophil count predicted the outcome of ARDS only in females, whereas testosterone plasma levels and lymphocytes counts only in males.

CONCLUSIONS

Sex is a biological variable affecting the choice of the correct biomarker that might predict worsening of COVID-19 to severe respiratory failure. The definition of sex specific biomarkers can be useful to alert patients to be safely discharged versus those who need respiratory monitoring.

摘要

背景

已经有一些生物标志物被确定可以预测 COVID-19 严重程度的结果，但关于它们在预测作用方面的性别差异的数据很少。本研究的目的是确定 COVID-19 中急性呼吸窘迫综合征（ARDS）严重程度和进展的性别特异性生物标志物。

方法

在入院时测量了男性和女性 COVID-19 患者的性激素（睾酮和 17β-雌二醇）、性激素依赖性循环分子（ACE2 和血管紧张素 1-7）和其他 COVID-19 严重程度的已知生物标志物的血浆水平。以聚合和性别分解的形式分析了血浆生物标志物水平与入院时 ARDS 严重程度以及住院期间呼吸恶化发生的相关性。

结果

我们的数据表明，一些生物标志物可以同时预测男性和女性患者，而另一些生物标志物只能预测一种性别。血管紧张素 1-7 血浆水平和中性粒细胞计数仅在女性中预测 ARDS 的结果，而睾酮血浆水平和淋巴细胞计数仅在男性中预测 ARDS 的结果。

结论

性别是影响选择可能预测 COVID-19 恶化至严重呼吸衰竭的正确生物标志物的生物学变量。定义性别特异性生物标志物可用于提醒患者安全出院与需要呼吸监测的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/98240538bc48/13293_2021_407_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/b2ffc7815000/13293_2021_407_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/bea43f602c0d/13293_2021_407_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/98240538bc48/13293_2021_407_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/b2ffc7815000/13293_2021_407_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/bea43f602c0d/13293_2021_407_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b30/8607583/98240538bc48/13293_2021_407_Fig3_HTML.jpg

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