Tozoni Sara Soares, Gadotti Ana Carolina, Dias Erika Sousa, Monte Alegre Julia Bacarin, Von Spitzenbergen Beatriz Akemi, Deus Marina de Castro, de Moraes Thyago Proença, Moreno-Amaral Andrea Novais
Pós-Graduação em Ciências da Saúde, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, Brazil.
Int J Mol Sci. 2025 Jun 25;26(13):6086. doi: 10.3390/ijms26136086.
About a quarter of COVID-19 patients develop acute kidney injury (AKI), worsening prognosis and increasing mortality. Severe COVID-19 often triggers a hyperactive immune response, influencing disease outcomes. This study examined the correlation between kidney injury biomarkers, inflammatory mediators, and mortality in COVID-19 patients. Blood samples from 390 COVID-19 patients were collected at admission and before the outcome. Serum Cystatin C (CysC), albumin, and plasma NGAL were measured via nephelometry, while inflammatory mediators (IL-4, IL-6, IL-10, IL-15, IFN-γ, TNF-α, and IL-1β) were assessed by ELISA. Most patients were male, with hypertension and diabetes as common comorbidities, and a high ICU admission rate. Lower albumin and elevated CysC and NGAL were linked to mortality. Increased inflammatory mediators correlated with lower albumin and higher CysC and NGAL, reinforcing the connection between systemic inflammation and kidney dysfunction. Elevated cytokines and kidney injury biomarkers, including NGAL, CysC, and low albumin, are strongly associated with higher mortality in COVID-19 patients. These findings highlight the role of inflammation and kidney function markers in identifying high-risk individuals, improving patient management, and mitigating complications. Monitoring these biomarkers remains crucial for managing long-term health impacts and future outbreaks.
约四分之一的新冠病毒肺炎(COVID-19)患者会发生急性肾损伤(AKI),这会使预后恶化并增加死亡率。重症COVID-19常引发免疫反应亢进,影响疾病转归。本研究检测了COVID-19患者肾损伤生物标志物、炎症介质与死亡率之间的相关性。收集了390例COVID-19患者入院时及预后前的血样。血清胱抑素C(CysC)、白蛋白以及血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)通过比浊法测定,而炎症介质(白细胞介素-4、白细胞介素-6、白细胞介素-10、白细胞介素-15、干扰素-γ、肿瘤坏死因子-α和白细胞介素-1β)通过酶联免疫吸附测定(ELISA)进行评估。大多数患者为男性,常见合并症为高血压和糖尿病,入住重症监护病房(ICU)的比例较高。白蛋白降低以及CysC和NGAL升高与死亡率相关。炎症介质增加与白蛋白降低以及CysC和NGAL升高相关,强化了全身炎症与肾功能障碍之间的联系。细胞因子升高以及包括NGAL、CysC和低白蛋白在内的肾损伤生物标志物与COVID-19患者较高的死亡率密切相关。这些发现凸显了炎症和肾功能标志物在识别高危个体、改善患者管理及减轻并发症方面的作用。监测这些生物标志物对于控制长期健康影响和未来疫情仍至关重要。