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Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection

INTRODUCTION: Stress hyperglycemia is a frequent finding in patients with COVID-19 infection and could affect the outcome of disease. Cytokines released in response to infection could have adverse effects on insulin sensitivity and pancreatic beta-cell function. The aim of the study was to examine t...

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Autores principales: Da Porto, Andrea, Tascini, Carlo, Colussi, Gianluca, Peghin, Maddalena, Graziano, Elena, De Carlo, Chiara, Bulfone, Luca, Antonello, Martina, Sozio, Emanuela, Fabris, Martina, Curcio, Francesco, Pucillo, Carlo, Catena, Cristiana, Sechi, Leonardo A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437426/
https://www.ncbi.nlm.nih.gov/pubmed/36059840
http://dx.doi.org/10.3389/fmed.2022.988686
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author Da Porto, Andrea
Tascini, Carlo
Colussi, Gianluca
Peghin, Maddalena
Graziano, Elena
De Carlo, Chiara
Bulfone, Luca
Antonello, Martina
Sozio, Emanuela
Fabris, Martina
Curcio, Francesco
Pucillo, Carlo
Catena, Cristiana
Sechi, Leonardo A.
author_facet Da Porto, Andrea
Tascini, Carlo
Colussi, Gianluca
Peghin, Maddalena
Graziano, Elena
De Carlo, Chiara
Bulfone, Luca
Antonello, Martina
Sozio, Emanuela
Fabris, Martina
Curcio, Francesco
Pucillo, Carlo
Catena, Cristiana
Sechi, Leonardo A.
author_sort Da Porto, Andrea
collection PubMed
description INTRODUCTION: Stress hyperglycemia is a frequent finding in patients with COVID-19 infection and could affect the outcome of disease. Cytokines released in response to infection could have adverse effects on insulin sensitivity and pancreatic beta-cell function. The aim of the study was to examine the relationships of stress hyperglycemia with cytokines and clinical outcomes in hospitalized patients with COVID-19. METHODS: In a cross-sectional analysis of 150 patients hospitalized for COVID-19 infection who were included in the GIRA-COVID database, we identified patients with stress hyperglycemia by calculation of the Stress Hyperglycemia Ratio (SHR) and use of a cut-off of 1.14. Plasma levels of cytokines principally involved in COVID-19 infection-related cytokine storm were measured. Outcome variables were use of mechanical ventilation and death within 60 days from hospital admission. RESULTS: Patients with SHR > 1.14 had significantly higher plasma insulin, HOMA-index, and levels of interleukin-10 (IL-10), interleukin-10/tumor necrosis factor-a ratio (IL-10/TNF-α), and CXC motif chemokine ligand 10 (CXCL10) than patients with SHR ≤ 1.14. IL-10, IL-10/TNF-α ratio, CXCL10, and IFN-γ were significantly and directly related with SHR in univariate analysis and multivariate logistic regression models showed that IL-10, IL-10/TNF-α ratio, and CXCL10 were independently associated with SHR>1.14. In a multivariate logistic model, stress hyperglycemia predicted use of mechanical ventilation (OR 2.453; CI 1.078–6.012) and death (OR 2.281; CI 1.049–7.369) independently of diabetes and other major confounders. CONCLUSIONS: In patients hospitalized for COVID-19 infection, stress hyperglycemia is associated with worse clinical outcomes and is independently related to levels of cytokines that might impair glucose homeostasis.
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spelling pubmed-94374262022-09-03 Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection Da Porto, Andrea Tascini, Carlo Colussi, Gianluca Peghin, Maddalena Graziano, Elena De Carlo, Chiara Bulfone, Luca Antonello, Martina Sozio, Emanuela Fabris, Martina Curcio, Francesco Pucillo, Carlo Catena, Cristiana Sechi, Leonardo A. Front Med (Lausanne) Medicine INTRODUCTION: Stress hyperglycemia is a frequent finding in patients with COVID-19 infection and could affect the outcome of disease. Cytokines released in response to infection could have adverse effects on insulin sensitivity and pancreatic beta-cell function. The aim of the study was to examine the relationships of stress hyperglycemia with cytokines and clinical outcomes in hospitalized patients with COVID-19. METHODS: In a cross-sectional analysis of 150 patients hospitalized for COVID-19 infection who were included in the GIRA-COVID database, we identified patients with stress hyperglycemia by calculation of the Stress Hyperglycemia Ratio (SHR) and use of a cut-off of 1.14. Plasma levels of cytokines principally involved in COVID-19 infection-related cytokine storm were measured. Outcome variables were use of mechanical ventilation and death within 60 days from hospital admission. RESULTS: Patients with SHR > 1.14 had significantly higher plasma insulin, HOMA-index, and levels of interleukin-10 (IL-10), interleukin-10/tumor necrosis factor-a ratio (IL-10/TNF-α), and CXC motif chemokine ligand 10 (CXCL10) than patients with SHR ≤ 1.14. IL-10, IL-10/TNF-α ratio, CXCL10, and IFN-γ were significantly and directly related with SHR in univariate analysis and multivariate logistic regression models showed that IL-10, IL-10/TNF-α ratio, and CXCL10 were independently associated with SHR>1.14. In a multivariate logistic model, stress hyperglycemia predicted use of mechanical ventilation (OR 2.453; CI 1.078–6.012) and death (OR 2.281; CI 1.049–7.369) independently of diabetes and other major confounders. CONCLUSIONS: In patients hospitalized for COVID-19 infection, stress hyperglycemia is associated with worse clinical outcomes and is independently related to levels of cytokines that might impair glucose homeostasis. Frontiers Media S.A. 2022-08-19 /pmc/articles/PMC9437426/ /pubmed/36059840 http://dx.doi.org/10.3389/fmed.2022.988686 Text en Copyright © 2022 Da Porto, Tascini, Colussi, Peghin, Graziano, De Carlo, Bulfone, Antonello, Sozio, Fabris, Curcio, Pucillo, Catena and Sechi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Da Porto, Andrea
Tascini, Carlo
Colussi, Gianluca
Peghin, Maddalena
Graziano, Elena
De Carlo, Chiara
Bulfone, Luca
Antonello, Martina
Sozio, Emanuela
Fabris, Martina
Curcio, Francesco
Pucillo, Carlo
Catena, Cristiana
Sechi, Leonardo A.
Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection
title Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection
title_full Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection
title_fullStr Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection
title_full_unstemmed Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection
title_short Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection
title_sort relationship between cytokine release and stress hyperglycemia in patients hospitalized with covid-19 infection
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437426/
https://www.ncbi.nlm.nih.gov/pubmed/36059840
http://dx.doi.org/10.3389/fmed.2022.988686
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