Research Laboratory LR12DN01, Military Hospital of Tunis, Tunis, Tunisia.
Department of Intensive Care, Military Hospital of Tunis, Tunis, Tunisia.
J Med Virol. 2023 Apr;95(4):e28728. doi: 10.1002/jmv.28728.
As elevated levels of the soluble CXCL16 (sCXCL16) chemokine have been reported in severe coronavirus disease 2019 (COVID-19) patients, this study examined whether sCXCL16 concentration on the first day of hospitalization predicted death in COVID-19 patients. A total of 76 patients with COVID-19 were admitted to the Military Hospital of Tunis, Tunisia, between October 2020 and April 2021, and later classified as survivors or nonsurvivors based on their outcomes. At admission, the groups were matched by age, gender, comorbidities, and the percentage of patients with moderate conditions. On the first day of admission, serum's sCXCL16 concentrations were measured using a magnetic-bead assay. There was an eightfold increase in serum sCXCL16 levels in the nonsurvivors' group (3661.51 ± 2464.87 pg/mL vs. 454.3 ± 338.07 pg/mL, p < 0.0001). For the optimal cutoff value of sCXCL16 at 2095 pg/mL, we found a 94.6% sensitivity and a 97.4% specificity, with an area under curve of 0.981 (p = 5.03E-08; 95% confidence interval [95% CI]: 0.951-1.0114). Considering the risk of death at a concentration above the threshold, the unadjusted odds ratio was 36 (p < 0.0001). The adjusted odd ratio was estimated at 1.003 (p < 0.0001; 95% CI: 1.002-1.004). Finally, there was a significant difference between survival and nonsurvival groups in leukocyte numbers (p = 0.006), lymphocytes (p = 0.001), polymorphonuclear neutrophils (p = 0.001), and C-reactive protein levels (p = 0.007), except for monocytes (p = 0.881). Based on these results, sCXCL16 level could be used for detecting nonsurvival COVID-19 patients. Therefore, we recommend assessing this marker in hospitalized COVID-19 patients.
由于可溶性趋化因子配体 16(sCXCL16)水平升高已在严重的 2019 冠状病毒病(COVID-19)患者中报告,本研究旨在探讨 COVID-19 患者入院第 1 天的 sCXCL16 浓度是否可预测死亡。2020 年 10 月至 2021 年 4 月,突尼斯突尼斯军事医院收治了 76 例 COVID-19 患者,根据结局将其分为存活者和非存活者。入院时,根据年龄、性别、合并症和中等严重程度患者的百分比对两组进行匹配。入院第 1 天,使用磁珠法检测血清 sCXCL16 浓度。非存活者组的血清 sCXCL16 水平升高了 8 倍(3661.51±2464.87pg/ml 比 454.3±338.07pg/ml,p<0.0001)。对于 2095pg/ml 的最佳 sCXCL16 截断值,我们发现灵敏度为 94.6%,特异性为 97.4%,曲线下面积为 0.981(p=5.03E-08;95%置信区间[95%CI]:0.951-1.0114)。考虑到高于阈值时死亡的风险,未调整的优势比为 36(p<0.0001)。调整后的优势比估计为 1.003(p<0.0001;95%CI:1.002-1.004)。最后,在白细胞数量(p=0.006)、淋巴细胞(p=0.001)、多形核中性粒细胞(p=0.001)和 C 反应蛋白水平(p=0.007)方面,存活组和非存活组之间存在显著差异,除单核细胞外(p=0.881)。基于这些结果,sCXCL16 水平可用于检测 COVID-19 非存活患者。因此,我们建议评估住院 COVID-19 患者的这种标志物。