背景:全身炎症是与COVID-19进展紧密交织的关键因素。这项研究试图阐明三个关键炎症分子的意义,也就是说,肝素结合蛋白(HBP),白细胞介素-6(IL-6),和C反应蛋白(CRP),评估COVID-19的严重程度和预后意义。
方法:人口统计,临床,回顾性收集214例确诊为COVID-19的成年患者的实验室数据.患者分为两组:非严重组(n=93;43.5%)和严重组(n=121;56.5%)。此外,根据他们的器官功能,患者分为非器官功能衰竭组(n=137)和器官功能衰竭组(n=77).然后在这些定义的组中比较炎症相关细胞因子的水平。
结果:严重组的特征是男性比例更高,年龄较大,与非严重病例相比,住院时间更长。此外,严重病例表现出更高的基础疾病和器官衰竭的患病率。统计分析显示HBP水平显著升高,重度组IL-6和CRP。HBP,IL-6和CRP被确定为重症COVID-19的独立危险因素。此外,对这些生物标志物的联合评估显示,预测COVID-19严重程度的诊断敏感性(85.10%)和特异性(95.70%)较高.HBP升高,还观察到IL-6和CRP水平以及器官功能受损。当两个或多个组合使用时,预测效率显着提高(风险比=3.631,对数秩p=0.003)。值得注意的是,HBP水平升高,IL-6和CRP与死亡风险增加相关。
结论:结论:HBP的联合评估,IL-6和CRP在预测严重程度方面提供了更高的准确性和特异性,器官衰竭,和与COVID-19相关的死亡风险。
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.