Prediction of Clinical Severity of COVID-19 Using a Combination of Heparin-Binding Protein, Interleukin-6, and C-Reactive Protein: A Retrospective Study

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-08-26 DOI:10.1111/crj.70003

Yidan Gao, Ke Zhao, Jing Liu, Xiangbo Zhang, Ling Gong, Xiang Zhou, Gongying Chen

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Abstract

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.

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使用肝素结合蛋白、白细胞介素-6 和 C 反应蛋白组合预测 COVID-19 的临床严重程度：一项回顾性研究。

背景：全身性炎症是与 COVID-19 的进展紧密交织在一起的关键因素。本研究试图阐明肝素结合蛋白（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 的严重程度和预后影响方面的意义：回顾性收集了 214 名确诊为 COVID-19 的成年患者的人口统计学、临床和实验室数据。患者分为两组：非重度（93 人；43.5%）和重度（121 人；56.5%）。此外，根据器官功能，患者被分为非器官衰竭组（n = 137）和器官衰竭组（n = 77）。然后比较这些组别中炎症相关细胞因子的水平：结果：与非重症病例相比，重症组男性比例更高、年龄更大、住院时间更长。此外，重症病例患有基础疾病和器官衰竭的比例更高。统计分析显示，重症组的 HBP、IL-6 和 CRP 水平明显升高。HBP、IL-6 和 CRP 被确定为严重 COVID-19 的独立危险因素。此外，对这些生物标志物的综合评估显示，预测 COVID-19 严重程度的诊断灵敏度（85.10%）和特异性（95.70%）都很高。此外，还观察到 HBP、IL-6 和 CRP 水平升高与器官功能受损之间存在正相关关系。当合并使用其中两种或两种以上时，预测效率明显提高（危险比 = 3.631，对数秩 P = 0.003）。值得注意的是，HBP、IL-6 和 CRP 水平升高与死亡风险增加有关：总之，联合评估 HBP、IL-6 和 CRP 可提高预测 COVID-19 的严重程度、器官衰竭和死亡风险的准确性和特异性。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)