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血清β-2 微球蛋白水平升高可预测急性奥密克戎变异株 COVID-19 感染患者短期预后不良。

Elevated serum beta-2 microglobulin level predicts short-term poor prognosis of patients with acute omicron variant COVID-19 infection.

机构信息

Cancer Radiotherapy and Chemotherapy Center, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.

Laboratory of Stem Cell Transplantation, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.

出版信息

Front Cell Infect Microbiol. 2023 Jul 13;13:1204326. doi: 10.3389/fcimb.2023.1204326. eCollection 2023.

Abstract

BACKGROUND

The devastating coronavirus disease of 2019 (COVID-2019) epidemic has been declared a public health emergency, resulting in a worldwide pandemic. The omicron variety is the most common epidemic mutant strain in the globe. Serum beta-2 microglobulin (β2-MG) is associated with endothelial cell injury and has value in monitoring the progression of inflammation in infected individuals. Nonetheless, the potential functions of β2-MG in omicron remain elusive.

METHODS

To investigate the prognostic value of serum β2-MG levels at diagnosis, we retrospectively analyzed a cohort of 240 people with omicron. Over the course of 65 days, all patients were monitored, and death was the primary outcome. Patients were allocated to two groups: those with high and low β2-MG levels. The Kaplan-Meier method was used to examine OS, and the log-rank test was used to compare them. Univariate and multivariate Cox hazard models were used to determine the prognostic significance.

RESULTS

Our results revealed that β2-MG was significantly elevated in omicron. β2-MG levels in severe patients were higher than in mild-to-moderate patients, and the difference was statistically significant. Timely, interleukin-6 (IL-6) and interleukin-10 (IL-10) were observed to be significantly increased in individuals exhibiting elevated levels of β2-MG. In addition, patients exhibiting elevated levels of β2-MG demonstrated a statistically significant decrease in overall survival (OS, < 0.0001). An elevated β2-MG level (≥4.72 mg/l) was found to be an independent, adverse prognostic factor for OS in omicron patients, according to multivariate Cox proportional hazards regression analysis ( = 0.001).

CONCLUSION

Serum β2-MG level at initial diagnosis was significantly correlated with omicron severity and prognosis. Thus, we propose that β2-MG may be an independent poor additional prognostic factor in patients with omicron.

摘要

背景

2019 年冠状病毒病(COVID-19)疫情已被宣布为公共卫生紧急事件,导致全球大流行。奥密克戎变体是全球最常见的流行突变株。血清β-2 微球蛋白(β2-MG)与内皮细胞损伤有关,在监测感染个体炎症进展方面具有价值。然而,β2-MG 在奥密克戎中的潜在功能仍不清楚。

方法

为了研究诊断时血清β2-MG 水平的预后价值,我们回顾性分析了 240 名奥密克戎患者的队列。在 65 天的时间里,对所有患者进行监测,以死亡为主要结局。将患者分为两组:β2-MG 水平高和低。采用 Kaplan-Meier 法分析 OS,采用对数秩检验比较。采用单因素和多因素 Cox 风险模型确定预后意义。

结果

我们的结果表明,β2-MG 在奥密克戎中显著升高。重症患者β2-MG 水平高于轻症至中度患者,差异有统计学意义。及时观察到,β2-MG 水平升高的个体中白细胞介素-6(IL-6)和白细胞介素-10(IL-10)显著升高。此外,β2-MG 水平升高的患者总生存(OS)显著降低(<0.0001)。多因素 Cox 比例风险回归分析显示,β2-MG 升高(≥4.72mg/L)是奥密克戎患者 OS 的独立不良预后因素(=0.001)。

结论

初始诊断时血清β2-MG 水平与奥密克戎严重程度和预后显著相关。因此,我们提出β2-MG 可能是奥密克戎患者独立的不良预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65ca/10373586/e0d82179f6e2/fcimb-13-1204326-g001.jpg

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