Cîrjaliu Roxana-Elena, Tofolean Ioan-Tiberiu, Tofolean Doina-Ecaterina, Chisoi Anca, Oancea Cristian, Vastag Emanuela, Marc Monica, Bratosin Felix, Rosca Ovidiu, Fildan Ariadna-Petronela
Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania.
Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), "Ovidius" University of Constanta, 900591 Constanta, Romania.
Biomedicines. 2024 Jul 10;12(7):1532. doi: 10.3390/biomedicines12071532.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitates advanced prognostic tools to anticipate disease progression and optimize patient outcomes. This study evaluates the predictive value and diagnostic potential of interleukins interleukin (IL) IL-10, IL-17A, IL1-β, IL-6, chemokine ligand (CXCL), and Monocyte Chemotactic Protein (MCP) for severe coronavirus disease 2019 (COVID-19) and COVID-19 mortality, aiming to correlate cytokine levels with disease severity. Conducted from January 2023 to January 2024, this prospective cohort study involved patients hospitalized with moderate and severe COVID-19 from Romania. This study analyzed statistically significant predictors of severe COVID-19 outcomes. IL-6 and MCP emerged as significant, with hazard ratios (HRs) of 2.35 (95% confidence interval (CI): 1.54-3.59, = 0.014) and 2.05 (95% CI: 1.22-3.45, = 0.007), respectively. Compound scores integrating multiple inflammatory markers also demonstrated predictive value; Compound Score 2 had an HR of 2.23 (95% CI: 1.35-3.68, = 0.002), surpassing most single markers in association with severe disease. Notably, interleukins IL-10 and IL-1β did not show significant associations with disease severity. This study underscores the importance of IL-6 and MCP as robust predictors of severe COVID-19, substantiating their role in clinical assessments to foresee patient deterioration. The utility of compound scores in enhancing predictive accuracy suggests a composite approach may be more effective in clinical settings.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）需要先进的预后工具来预测疾病进展并优化患者预后。本研究评估白细胞介素IL-10、IL-17A、IL1-β、IL-6、趋化因子配体（CXCL）和单核细胞趋化蛋白（MCP）对重症2019冠状病毒病（COVID-19）及COVID-19死亡率的预测价值和诊断潜力，旨在将细胞因子水平与疾病严重程度相关联。这项前瞻性队列研究于2023年1月至2024年1月进行，纳入了罗马尼亚因中度和重度COVID-19住院的患者。本研究分析了重症COVID-19预后的统计学显著预测因素。IL-6和MCP具有显著性，风险比（HR）分别为2.35（95%置信区间（CI）：1.54 - 3.59，P = 0.014）和2.05（95%CI：1.22 - 3.45，P = 0.007）。整合多种炎症标志物的复合评分也显示出预测价值；复合评分2的HR为2.23（95%CI：1.35 - 3.68，P = 0.002），在与重症疾病的关联方面超过了大多数单一标志物。值得注意的是，白细胞介素IL-10和IL-1β与疾病严重程度未显示出显著关联。本研究强调了IL-6和MCP作为重症COVID-19有力预测指标的重要性，证实了它们在临床评估中预测患者病情恶化的作用。复合评分在提高预测准确性方面显示出的效用表明，综合方法在临床环境中可能更有效。
