白细胞介素-8、C反应蛋白（CRP）与中性粒细胞与淋巴细胞比值（NLR）之间的相关性作为合并糖尿病的COVID-19患者死亡率的预测指标
Correlation Between IL-8, C-Reactive Proteins (CRP) and Neutrophil to Lymphocyte Ratio (NLR) as Predictor of Mortality in COVID-19 Patients with Diabetes Mellitus Comorbidity.
作者信息
Iskandar Agustin, Mayashinta Dearikha K, Robert Robert, Samsu Nur, Endharti Agustina Tri, Widjajanto Edy
机构信息
Doctoral Program in Medical Science, Faculty of Medicine, Universitas Brawijaya/Saiful Anwar General Hospital, Malang, Indonesia.
Department of Parasitology, Faculty of Medicine, Universitas Brawijaya/Saiful Anwar General Hospital, Malang, Indonesia.
出版信息
Int J Gen Med. 2023 Jun 8;16:2349-2354. doi: 10.2147/IJGM.S412070. eCollection 2023.
BACKGROUND
COVID-19 is caused by SARS-CoV-2 and has a wide range of symptoms. While Diabetes Mellitus (DM) is a common comorbidity in COVID-19 patients, it is the main comorbidity in non-surviving COVID-19 patients. Interleukin-8 (IL-8) is a cytokine that has been correlated with severity and mortality in COVID-19 patients, but its role in COVID-19 patients with DM comorbidity and its relationship with NLR and CRP as markers of inflammation are not yet fully understood.
OBJECTIVE
To investigate the correlation between IL-8, NLR, and CRP in COVID-19 patients with DM comorbidity.
METHODS
A cross-sectional study was conducted at the Integrated Infectious Disease Installation of Dr. Saiful Anwar Malang Hospital from June to November 2021 using consecutive sampling. IL-8 was measured using the ELISA method with Legendmax Human IL-8. NLR was measured using flow cytometry, while CRP was measured using the immunoturbidimetric method with Cobas C6000. Patient outcomes were obtained from medical records.
RESULTS
A total of 124 research subjects participated in the study. IL-8 and CRP levels were significantly higher (p < 0.05) in COVID-19 patients with DM comorbidity, and were also significantly higher (p < 0.05) in non-surviving COVID-19 patients. Overall, there was a positive correlation between IL-8 and CRP (r = 0.58, p < 0.05). There was also a positive correlation between IL-8 (r = 0.58; p < 0.05), NLR (r = 0.45, p < 0.05), CRP (r = 0.54, p < 0.05) and mortality in COVID-19 patients with DM comorbidity. The presence of DM comorbidity increased IL-8 levels and aggravated inflammation in COVID-19 patients, thereby increasing the risk of mortality.
CONCLUSION
IL-8, CRP and NLR levels were higher in non-surviving COVID-19 patients with DM comorbidity, indicating that they could serve as good predictors of poor outcomes in this patient population.
背景
新型冠状病毒肺炎（COVID-19）由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，症状多样。糖尿病（DM）是COVID-19患者常见的合并症，也是COVID-19死亡患者的主要合并症。白细胞介素-8（IL-8）是一种细胞因子，与COVID-19患者的病情严重程度和死亡率相关，但其在合并DM的COVID-19患者中的作用以及与作为炎症标志物的中性粒细胞与淋巴细胞比值（NLR）和C反应蛋白（CRP）的关系尚未完全明确。
目的
探讨合并DM的COVID-19患者中IL-8、NLR和CRP之间的相关性。
方法
2021年6月至11月，在赛义夫·安瓦尔博士玛琅医院综合传染病科采用连续抽样法进行横断面研究。使用Legendmax人IL-8酶联免疫吸附测定（ELISA）法检测IL-8。采用流式细胞术检测NLR，使用Cobas C6000免疫比浊法检测CRP。患者结局从病历中获取。
结果
共有124名研究对象参与研究。合并DM的COVID-19患者的IL-8和CRP水平显著更高（p<0.05），在COVID-19死亡患者中也显著更高（p<0.05）。总体而言，IL-8与CRP之间存在正相关（r=0.58，p<0.05）。在合并DM的COVID-19患者中，IL-8（r=0.58；p<0.05）、NLR（r=0.45，p<0.05）、CRP（r=0.54，p<0.05）与死亡率之间也存在正相关。合并DM会增加COVID-19患者的IL-8水平并加重炎症，从而增加死亡风险。
结论
合并DM的COVID-19死亡患者的IL-8、CRP和NLR水平更高，表明它们可作为该患者群体不良结局的良好预测指标。
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