Abstract
Background: Severe acute respiratory syndrome caused by novel coronavirus 2 (SARS-CoV-2) emerged in Wuhan (China) in December 2019. Here we evaluated a panel of biomarkers to phenotype patients and to define the role of immuno-inflammatory mediators as biomarkers of severity.
Materials and methods: Serum samples were obtained from 24 COVID-19 patients on admission to hospital, before any treatment or infusion of intravenous steroids or invasive ventilation. KL-6 IL-6 and C-peptide were measured by chemiluminescent enzyme immunoassay. IL-6 assay was validated for accuracy and precision. The validity of variables used to distinguish severe from mild-to-moderate patients was assessed by areas under curves (AUC) of the receiver operating characteristic (ROC) and logistic regression was performed to combine parameters of the two groups.
Results: In the severe group, IL-6, CRP and KL-6 concentrations were significantly higher than in mild-to-moderate patients. KL-6, IL-6 and CRP concentrations were directly correlated with each other. ROC curve analysis of the logistic regression model including IL-6, KL-6 and CRP showed the best performance with an AUC of 0.95.
Conclusions: Besides corroborating previous reports of over-expression of IL-6 in severe COVID-19 patients requiring mechanical ventilation, analytical determination of other mediators showed that IL-6 concentrations were correlated with those of KL-6 and CRP. The combination of these three prognostic bioindicators made it possible to distinguish severe COVID-19 patients with poor prognosis from mild-to-moderate patients.
Keywords: Biomarkers; COVID-19; IL-6; KL-6.
【저자키워드】 COVID-19, Biomarkers, IL-6, KL-6, 【초록키워드】 Treatment, SARS-CoV-2, Biomarker, Biomarkers, mechanical ventilation, IL-6, severity, hospital, CRP, Steroids, coronavirus 2, invasive ventilation, Novel coronavirus, China, Severe acute respiratory syndrome, immunoassay, ROC, Accuracy, Wuhan, Patient, Validity, Logistic regression, phenotype, enzyme immunoassay, prognostic, respiratory, characteristic, Admission, patients, C-peptide, infusion, Combination, Concentration, Analysis, COVID-19 patient, ROC Curve, Mild-to-moderate, AUC, steroid, intravenous, mediators, best, on admission, receiver operating characteristic, acute respiratory syndrome, Precision, accuracy and precision, two groups, serum samples, enzyme, severe group, logistic regression model, severe COVID-19 patients, poor prognosis, material, over-expression, serum sample, parameter, variable, caused, evaluated, was performed, correlated, significantly higher, to define, were measured, immuno-inflammatory, severe COVID-19 patient, 【제목키워드】 severe COVID-19 patient,