Role of interleukin-6, serum ferritin, and d-dimer in hospitalized COVID-19 patients

IF 3.7 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Cytokine Pub Date : 2024-10-08 DOI:10.1016/j.cyto.2024.156776

Praveen Gupta , Anunay Gupta , Sandeep Bansal , Monica Sharma , Sumita Saluja , Ira Balakrishnan , Kapil Gupta

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Abstract

Background

Various studies have observed an association between interleukin-6 (IL-6), serum ferritin, d-dimer, and in-hospital mortality in COVID-19 patients. However, multivariate regression analysis was not done in the majority of the studies, Also, the role of interleukin-6 (IL-6), serum ferritin, and d-dimer in hospitalized COVID-19 patients was not adequately studied and reported from our region.

Method

It was a retrospective cohort study in which the serum IL-6, serum ferritin, and d-dimer of 305 hospitalized COVID-19 patients were analyzed, and their association with mortality was determined.

Results

In COVID-19 patients, the levels of IL-6 (P = 0.007), serum ferritin (P = 0.011), and d-dimer (P = 0.004) were significantly elevated in patients with severe SARS-CoV-2 illness (SpO2 < 90 % at admission). IL-6 levels were significantly elevated (186 pg/ml vs. 215 pg/ml, P = 0.003) in non-survivors compared to survivors. However, d-dimer (mg/ml) (P = 0.129) and serum ferritin (mg/ml) (P = 0.051) levels were similar between the two groups. The ROC curve (receiver operating characteristic curve) analysis showed a significant but poor area under the curve (AUC) between elevated IL-6 (>208 pg/ml) and in-hospital mortality (P < 0.008, AUC = 0.61). Kaplan-Meir survival analysis showed poor survival in patients with elevated IL-6 (>208 pg/ml) (P by log-rank: 0.010) and elevated d-dimer (>1780 mg/ml) (P by log-rank: 0.036). The multivariate cox-regression analysis did not show any association between IL-6, serum ferritin, d-dimer, and in-hospital mortality (P > 0.05). Also, no association was found between serum levels of IL-6, serum ferritin, d-dimer, and the use of a ventilator (P > 0.05) and the severity of SARS-CoV-2 illness (P > 0.05) on multivariate binary logistic regression analysis.

Conclusion

In this study, the serum levels of IL-6, serum ferritin, and d-dimer were not associated with in-hospital mortality in hospitalized COVID-19 patients on multivariate cox-regression analysis, and were the markers of severe SARS-CoV-2 illness.

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白细胞介素-6、血清铁蛋白和 d-二聚体在 COVID-19 住院患者中的作用。

背景：多项研究发现，白细胞介素-6（IL-6）、血清铁蛋白、二聚体与 COVID-19 患者的院内死亡率存在关联。此外，白细胞介素 6（IL-6）、血清铁蛋白和 d-二聚体在 COVID-19 住院患者中的作用在本地区也未得到充分研究和报道：这是一项回顾性队列研究，分析了305名COVID-19住院患者的血清IL-6、血清铁蛋白和d-二聚体，并确定了它们与死亡率的关系：结果：在COVID-19患者中，IL-6（P = 0.007）、血清铁蛋白（P = 0.011）和d-二聚体（P = 0.004）水平在SARS-CoV-2重症患者（SpO2 208 pg/ml）和院内死亡患者（P 208 pg/ml）中显著升高（P by log-rank：0.010），在d-二聚体升高（>1780 mg/ml）患者中显著升高（P by log-rank：0.036）。多变量考克斯回归分析未显示 IL-6、血清铁蛋白、d-二聚体与院内死亡率之间存在任何关联（P > 0.05）。此外，在多变量二元逻辑回归分析中，也未发现 IL-6、血清铁蛋白、d-二聚体的血清水平与使用呼吸机（P > 0.05）和 SARS-CoV-2 病情严重程度（P > 0.05）之间存在关联：结论：在本研究中，在多变量cox-回归分析中，血清IL-6、血清铁蛋白和d-二聚体水平与COVID-19住院患者的院内死亡率无关，它们是SARS-CoV-2病情严重程度的标志物。

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来源期刊

Cytokine 医学-免疫学

CiteScore

7.60

自引率

2.60%

发文量

262

审稿时长

48 days

期刊介绍： The journal Cytokine has an open access mirror journal Cytokine: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. * Devoted exclusively to the study of the molecular biology, genetics, biochemistry, immunology, genome-wide association studies, pathobiology, diagnostic and clinical applications of all known interleukins, hematopoietic factors, growth factors, cytotoxins, interferons, new cytokines, and chemokines, Cytokine provides comprehensive coverage of cytokines and their mechanisms of actions, 12 times a year by publishing original high quality refereed scientific papers from prominent investigators in both the academic and industrial sectors. We will publish 3 major types of manuscripts: 1) Original manuscripts describing research results. 2) Basic and clinical reviews describing cytokine actions and regulation. 3) Short commentaries/perspectives on recently published aspects of cytokines, pathogenesis and clinical results.