Soluble TNF receptors predict acute kidney injury and mortality in critically ill COVID-19 patients : A prospective observational study
| Autor: | Anders Larsson, Robert Frithiof, Michael Hultström, Elena Sancho Ferrando, Katja Hanslin, Miklos Lipcsey |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
TNFR Tumor necrosis factor receptors Organ Dysfunction Scores Biochemistry Severity of Illness Index Receptors Tumor Necrosis Factor PCR polymerase chain reaction SOFA Sequential organ failure assessment Immunology and Allergy Hospital Mortality Prospective Studies ELISA Enzyme-Linked ImmunoSorbent Assay TNF receptors COVID-19 Coronavirus disease 2019 biology Acute kidney injury Area under the curve Hematology Acute Kidney Injury Middle Aged ICU intensive care unit KDIGO Kidney Disease Improving Global Outcomes PCT Procalcitonin sTNFR Soluble tumor necrosis factor receptors Intensive Care Units PFR PaO2/FiO2 ratio CRP C-reactive protein Female medicine.medical_specialty Anestesi och intensivvård Critical Illness Multiple Organ Failure Immunology AKI acute kidney injury SAPS 3 Simplified acute physiology score 3 Article Internal medicine Severity of illness medicine Humans IL-6 Interleukin-6 MAP Median arterial blood pressure Molecular Biology RRT renal replacement therapy SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Receiver operating characteristic sTNFR 2 Soluble tumor necrosis factor receptor 2 Anesthesiology and Intensive Care business.industry Septic shock sTNFR 1 Soluble tumor necrosis factor receptor 1 SARS-CoV-2 TNF Tumor necrosis factor COVID-19 IQR Interquartile range medicine.disease AUC Area under the curve HR hazard ratio ROC receiver operating characteristic Ferritin Pneumonia Critical care Respiratory failure biology.protein business 95%CI 95% confidence interval Biomarkers |
| Zdroj: | Cytokine |
| Popis: | BACKGROUND: Although pneumonia is the hallmark of coronavirus disease 2019 (COVID-19), multiple organ failure may develop in severe disease. TNFalpha receptors in their soluble form (sTNFR) are involved in the immune cascade in other systemic inflammatory processes such as septic shock, and could mediate the inflammatory activation of distant organs. The aim of this study is to analyse plasma levels of sTNFR 1 and 2 in association with organ failure and outcome in critically ill patients with COVID-19. METHODS: After informed consent, we included 122 adult patients with PCR-confirmed COVID-19 at ICU admission. Demographic data, illness severity scores, organ failure and survival at 30 days were collected. Plasma sTNFR 1 and 2 levels were quantified during the first days after ICU admission. Twenty-five healthy blood donors were used as control group. RESULTS: Levels of sTNFR were higher in severe COVID-19 patients compared to controls (p < 0.001). Plasma levels of sTNFR were associated to illness severity scores (SAPS 3 and SOFA), inflammation biomarkers such as IL-6, ferritin and PCT as well as development of AKI during ICU stay. sTNFR 1 higher than 2.29 ng/mL and? sTNFR 2 higher than 11.7 ng/mL were identified as optimal cut-offs to discriminate survivors and non-survivors 30 days after ICU admission and had an area under the curve in receiver operating characteristic curve of 0.75 and 0.67 respectively. CONCLUSION: Plasma levels of sTNFR 1 and 2 were higher in COVID-19 patients compared to controls and were strongly associated with other inflammatory biomarkers, severity of illness and acute kidney injury development during ICU stay. In addition, sTNFR 1 was an independent predictor of 30-day mortality after adjustment for age and respiratory failure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|