Department of Hepatology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.
Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang, China.
Clin Respir J. 2024 Aug;18(8):e70003. doi: 10.1111/crj.70003.
Systemic inflammation stands as a pivotal factor tightly interwoven with the progression of COVID-19. This study endeavors to elucidate the significance of three key inflammatory molecules, that is, heparin-binding protein (HBP), interleukin-6 (IL-6), and C-reactive protein (CRP), in assessing the severity and prognostic implications of COVID-19.
The demographic, clinical, and laboratory data were retrospectively collected from a cohort of 214 adult patients diagnosed with COVID-19. Patients were divided into two groups: nonsevere (n = 93; 43.5%) and severe (n = 121; 56.5%). Additionally, based on their organ function, patients were categorized into nonorgan failure (n = 137) and organ failure (n = 77) groups. The levels of inflammation-related cytokines were then compared among these defined groups.
The severe group was characterized by a higher proportion of males, older age, and longer hospital stays compared to nonsevere cases. Additionally, severe cases exhibited a higher prevalence of underlying diseases and organ failure. Statistical analysis revealed significantly elevated levels of HBP, IL-6, and CRP in the severe group. HBP, IL-6, and CRP were identified as independent risk factors for severe COVID-19. Furthermore, a combined assessment of these biomarkers demonstrated superior diagnostic sensitivity (85.10%) and specificity (95.70%) for predicting COVID-19 severity. A positive relationship between elevated HBP, IL-6, and CRP levels and impaired organ function was also observed. The predictive efficiency significantly increased (hazard ratio = 3.631, log-rank p = 0.003) when two or more of them were combinedly used. Notably, elevated levels of HBP, IL-6, and CRP were associated with an increased risk of mortality.
In conclusion, the combined assessment of HBP, IL-6, and CRP offers enhanced accuracy and specificity in predicting the severity, organ failure, and mortality risk associated with COVID-19.
全身炎症是与 COVID-19 进展紧密相关的关键因素。本研究旨在阐明肝素结合蛋白（HBP）、白细胞介素 6（IL-6）和 C 反应蛋白（CRP）这三种关键炎症分子在评估 COVID-19 严重程度和预后中的意义。
回顾性收集了 214 例成人 COVID-19 患者的人口统计学、临床和实验室数据。患者分为非重症组（n=93；43.5%）和重症组（n=121；56.5%）。此外，根据器官功能，患者分为非器官衰竭组（n=137）和器官衰竭组（n=77）。然后比较了这些定义组之间炎症相关细胞因子的水平。
重症组的男性比例、年龄较大和住院时间较长。此外，重症组更常见基础疾病和器官衰竭。统计分析显示，重症组 HBP、IL-6 和 CRP 水平显著升高。HBP、IL-6 和 CRP 是 COVID-19 重症的独立危险因素。此外，联合评估这些生物标志物对预测 COVID-19 严重程度具有较高的诊断敏感性（85.10%）和特异性（95.70%）。HBP、IL-6 和 CRP 水平升高与器官功能障碍呈正相关。当联合使用两种或更多种标志物时，预测效率显著增加（危险比=3.631，对数秩检验 p=0.003）。值得注意的是，HBP、IL-6 和 CRP 水平升高与死亡率增加相关。
综上所述，联合评估 HBP、IL-6 和 CRP 可提高预测 COVID-19 严重程度、器官衰竭和死亡风险的准确性和特异性。
