Ciotti Marco, Nuccetelli Marzia, Pieri Massimo, Petrangeli Carlo Maria, Giovannelli Alfredo, Cosio Terenzio, Rosa Luigi, Valenti Piera, Leonardis Francesca, Legramante Jacopo Maria, Bernardini Sergio, Campione Elena, Minieri Marilena
Virology Unit, Polyclinic Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Department of Laboratory Medicine, Polyclinic Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Diagnostics (Basel). 2022 Nov 2;12(11):2665. doi: 10.3390/diagnostics12112665.
Coronavirus disease 2019 (COVID-19) presents a clinical spectrum that ranges from a mild condition to critical illness. Patients with critical illness present respiratory failure, septic shock and/or multi-organ failure induced by the so called "cytokine storm". Inflammatory cytokines affect iron metabolism, mainly inducing the synthesis of hepcidin, a hormone peptide not routinely measured. High levels of hepcidin have been associated with the severity of COVID-19. The aim of this study was to analyze, retrospectively, the levels of hepcidin in a group of COVID-19 patients admitted to the intensive care unit (ICU) of the Policlinico Tor Vergata of Rome, Italy. Thirty-eight patients from November 2020 to May 2021 were enrolled in the study. Based on the clinical outcome, the patients were assigned to two groups: survivors and non-survivors. Moreover, a series of routine laboratory parameters were monitored during the stay of the patients in the ICU and their levels correlated to the outcome. Statistical differences in the level of hepcidin, D-dimer, IL-6, LDH, NLR, neutrophils level, CRP, TNF-α and transferrin were observed between the groups. In particular, hepcidin values showed significantly different median concentrations (88 ng/mL vs. 146 ng/mL) between survivors and non-survivors. In addition, ROC curves analysis revealed sensitivity and specificity values of 74% and 76%, respectively, at a cut-off of 127 (ng/mL), indicating hepcidin as a good biomarker in predicting the severity and mortality of COVID-19 in ICU patients.
2019冠状病毒病（COVID-19）临床表现多样，从轻症到危重症不等。危重症患者会出现呼吸衰竭、感染性休克和/或由所谓的“细胞因子风暴”引发的多器官功能衰竭。炎性细胞因子会影响铁代谢，主要诱导铁调素的合成，铁调素是一种非常规检测的激素肽。铁调素水平升高与COVID-19的严重程度相关。本研究旨在回顾性分析意大利罗马托尔韦尔加塔大学综合医院重症监护病房（ICU）收治的一组COVID-19患者的铁调素水平。2020年11月至2021年5月期间的38例患者纳入本研究。根据临床结局，将患者分为两组：存活者和非存活者。此外，在患者入住ICU期间监测了一系列常规实验室参数，并将其水平与结局进行关联分析。两组之间在铁调素、D-二聚体、白细胞介素-6、乳酸脱氢酶、中性粒细胞与淋巴细胞比值、中性粒细胞水平、C反应蛋白、肿瘤坏死因子-α和转铁蛋白水平上存在统计学差异。特别是，存活者和非存活者之间的铁调素值显示出显著不同的中位数浓度（88 ng/mL对146 ng/mL）。此外，ROC曲线分析显示，在截断值为127（ng/mL）时，敏感性和特异性值分别为74%和76%，表明铁调素是预测ICU中COVID-19患者严重程度和死亡率的良好生物标志物。
