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Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients
Risk stratification of coronavirus disease-19 (COVID-19) patients by simple markers is critical to guide treatment. We studied the predictive value of soluble interleukin-2 receptor (sIL-2R) for the early identification of patients at risk of developing severe clinical outcomes. sIL-2R levels were m...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025750/ https://www.ncbi.nlm.nih.gov/pubmed/35458517 http://dx.doi.org/10.3390/v14040787 |
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author | Gatselis, Nikolaos K. Lygoura, Vasiliki Lyberopoulou, Aggeliki Giannoulis, George Samakidou, Anna Vaiou, Antonia Vatidis, George Antoniou, Katerina Stefos, Aggelos Georgiadou, Sarah Sagris, Dimitrios Sveroni, Dafni Stergioula, Despoina Gabeta, Stella Ntaios, George Dalekos, George N. |
author_facet | Gatselis, Nikolaos K. Lygoura, Vasiliki Lyberopoulou, Aggeliki Giannoulis, George Samakidou, Anna Vaiou, Antonia Vatidis, George Antoniou, Katerina Stefos, Aggelos Georgiadou, Sarah Sagris, Dimitrios Sveroni, Dafni Stergioula, Despoina Gabeta, Stella Ntaios, George Dalekos, George N. |
author_sort | Gatselis, Nikolaos K. |
collection | PubMed |
description | Risk stratification of coronavirus disease-19 (COVID-19) patients by simple markers is critical to guide treatment. We studied the predictive value of soluble interleukin-2 receptor (sIL-2R) for the early identification of patients at risk of developing severe clinical outcomes. sIL-2R levels were measured in 197 patients (60.9% males; median age 61 years; moderate disease, n = 65; severe, n = 132, intubated and/or died, n = 42). All patients received combined immunotherapies (anakinra ± corticosteroids ± intravenous immunoglobulin ± tocilizumab) according to our local treatment algorithm. The endpoint was the composite event of intubation due to severe respiratory failure (SRF) or mortality. Median (interquartile range) sIL-2R levels were significantly higher in patients with severe disease, compared with those with moderate disease (6 (6.2) vs. 5.2 (3.4) ng/mL, p = 0.017). sIL-2R was the strongest laboratory predictive factor for intubation/death (hazard ratio 1.749, 95%CI 1.041–2.939, p = 0.035) after adjustment for other known risk factors. Youden’s index revealed optimal sIL-2R cut-off for predicting intubation/death at 9 ng/mL (sensitivity: 67%; specificity: 86%; positive and negative predictive value: 57% and 91%, respectively). Delta sIL-2R between the day of event or discharge minus admission date was higher in patients that intubated/died than in those who did not experience an event (2.91 (10.42) vs. 0.44 (2.88) ng/mL; p = 0.08)). sIL-2R on admission and its dynamic changes during follow-up may reflect disease severity and predict the development of SRF and mortality. |
format | Online Article Text |
id | pubmed-9025750 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90257502022-04-23 Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients Gatselis, Nikolaos K. Lygoura, Vasiliki Lyberopoulou, Aggeliki Giannoulis, George Samakidou, Anna Vaiou, Antonia Vatidis, George Antoniou, Katerina Stefos, Aggelos Georgiadou, Sarah Sagris, Dimitrios Sveroni, Dafni Stergioula, Despoina Gabeta, Stella Ntaios, George Dalekos, George N. Viruses Article Risk stratification of coronavirus disease-19 (COVID-19) patients by simple markers is critical to guide treatment. We studied the predictive value of soluble interleukin-2 receptor (sIL-2R) for the early identification of patients at risk of developing severe clinical outcomes. sIL-2R levels were measured in 197 patients (60.9% males; median age 61 years; moderate disease, n = 65; severe, n = 132, intubated and/or died, n = 42). All patients received combined immunotherapies (anakinra ± corticosteroids ± intravenous immunoglobulin ± tocilizumab) according to our local treatment algorithm. The endpoint was the composite event of intubation due to severe respiratory failure (SRF) or mortality. Median (interquartile range) sIL-2R levels were significantly higher in patients with severe disease, compared with those with moderate disease (6 (6.2) vs. 5.2 (3.4) ng/mL, p = 0.017). sIL-2R was the strongest laboratory predictive factor for intubation/death (hazard ratio 1.749, 95%CI 1.041–2.939, p = 0.035) after adjustment for other known risk factors. Youden’s index revealed optimal sIL-2R cut-off for predicting intubation/death at 9 ng/mL (sensitivity: 67%; specificity: 86%; positive and negative predictive value: 57% and 91%, respectively). Delta sIL-2R between the day of event or discharge minus admission date was higher in patients that intubated/died than in those who did not experience an event (2.91 (10.42) vs. 0.44 (2.88) ng/mL; p = 0.08)). sIL-2R on admission and its dynamic changes during follow-up may reflect disease severity and predict the development of SRF and mortality. MDPI 2022-04-10 /pmc/articles/PMC9025750/ /pubmed/35458517 http://dx.doi.org/10.3390/v14040787 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gatselis, Nikolaos K. Lygoura, Vasiliki Lyberopoulou, Aggeliki Giannoulis, George Samakidou, Anna Vaiou, Antonia Vatidis, George Antoniou, Katerina Stefos, Aggelos Georgiadou, Sarah Sagris, Dimitrios Sveroni, Dafni Stergioula, Despoina Gabeta, Stella Ntaios, George Dalekos, George N. Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
title | Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
title_full | Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
title_fullStr | Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
title_full_unstemmed | Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
title_short | Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
title_sort | soluble il-2r levels at baseline predict the development of severe respiratory failure and mortality in covid-19 patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025750/ https://www.ncbi.nlm.nih.gov/pubmed/35458517 http://dx.doi.org/10.3390/v14040787 |
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