肿瘤坏死因子相关凋亡诱导配体、γ干扰素诱导蛋白 10 和 C 反应蛋白在预测 SARS-CoV-2 感染进展中的作用：一项前瞻性队列研究。

BACKGROUND: Early prognostication of COVID-19 severity will potentially improve patient care. Biomarkers, such as TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10), and C-reactive protein (CRP), might represent possible tools for point-of-care testing and severity prediction. METHODS: In this prospective cohort study, we analyzed serum levels of TRAIL, IP-10, and CRP in patients with COVID-19, compared them with control subjects, and investigated the association with disease severity. RESULTS: A total of 899 measurements were performed in 132 patients (mean age 64 years, 40.2% females). Among patients with COVID-19, TRAIL levels were lower (49.5 vs 87 pg/ml, P = 0.0142), whereas IP-10 and CRP showed higher levels (667.5 vs 127 pg/ml, P <0.001; 75.3 vs 1.6 mg/l, P <0.001) than healthy controls. TRAIL yielded an inverse correlation with length of hospital and intensive care unit (ICU) stay, Simplified Acute Physiology Score II, and National Early Warning Score, and IP-10 showed a positive correlation with disease severity. Multivariable regression revealed that obesity (adjusted odds ratio [aOR] 5.434, 95% confidence interval [CI] 1.005-29.38), CRP (aOR 1.014, 95% CI 1.002-1.027), and peak IP-10 (aOR 1.001, 95% CI 1.00-1.002) were independent predictors of in-ICU mortality. CONCLUSIONS: We demonstrated a correlation between COVID-19 severity and TRAIL, IP-10, and CRP. Multivariable regression showed a role for IP-10 in predicting unfavourable outcomes, such as in-ICU mortality. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04655521.

背景：对 COVID-19 严重程度进行早期预测可能会改善患者的护理。肿瘤坏死因子相关凋亡诱导配体（TRAIL）、γ-干扰素诱导蛋白 10（IP-10）和 C 反应蛋白（CRP）等生物标志物可能是用于即时检测和严重程度预测的潜在工具。

方法：在这项前瞻性队列研究中，我们分析了 COVID-19 患者的血清 TRAIL、IP-10 和 CRP 水平，将其与对照组进行比较，并研究了与疾病严重程度的相关性。

结果：共对 132 例患者的 899 项测量结果进行了分析（平均年龄 64 岁，40.2%为女性）。与健康对照组相比，COVID-19 患者的 TRAIL 水平较低（49.5 与 87pg/ml，P=0.0142），而 IP-10 和 CRP 水平较高（667.5 与 127pg/ml，P<0.001；75.3 与 1.6mg/l，P<0.001）。TRAIL 与住院和重症监护病房（ICU）停留时间、简化急性生理学评分 II 和国家早期预警评分呈负相关，而 IP-10 与疾病严重程度呈正相关。多变量回归显示肥胖（调整后的优势比[aOR] 5.434，95%置信区间[CI] 1.005-29.38）、CRP（aOR 1.014，95% CI 1.002-1.027）和峰值 IP-10（aOR 1.001，95% CI 1.00-1.002）是 ICU 死亡率的独立预测因素。

结论：我们证明了 COVID-19 严重程度与 TRAIL、IP-10 和 CRP 之间存在相关性。多变量回归显示 IP-10 在预测不良结局（如 ICU 死亡率）方面具有作用。

临床试验注册：Clinicaltrials.gov，NCT04655521。