1. Prognostic value of interleukin-18 and its association with other inflammatory markers and disease severity in COVID-19
- Author
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Abdurrahman Tufan, Gülbin Aygencel, Murat Dizbay, Ozlem Gulbahar, Hasan Selçuk Özger, Kenan Hizel, Mehmet Akif Ozturk, Hasan Satış, Pinar Aysert Yildiz, Özlem Güzel Tunçcan, and Gonca Erbaş
- Subjects
musculoskeletal diseases ,Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Immunology ,Severity of Illness Index ,Asymptomatic ,Biochemistry ,Procalcitonin ,Article ,law.invention ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,law ,Internal medicine ,Severity of illness ,medicine ,Humans ,Immunology and Allergy ,Intensive care unit ,Molecular Biology ,Cytokine ,Aged ,Aged, 80 and over ,Inflammation ,Creatinine ,Interleukin-6 ,business.industry ,fungi ,Interleukin-18 ,COVID-19 ,Hematology ,Middle Aged ,medicine.disease ,Prognosis ,Pneumonia ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Macrophage activation syndrome ,Population study ,Female ,medicine.symptom ,business ,Biomarkers - Abstract
Highlights • Coronovirus 2019 (COVID-19) infection induces cytokine storm causing mortality. • Interleukin (IL)-18 is one of the key cytokines in the macrophage activation syndrome. • IL-18 elevated in COVID-19 patients and might be a therapeutic target., Background The effectual immune response is crucial to defeat viral infections. However, exuberant immune response with features of macrophage activation syndrome (MAS) lead detrimental consequences in COVID-19 patients. Interleukin (IL)-18 is one of the leading cytokines in MAS which has not been studied in COVID-19. Objective To investigate the association of IL-18 with the other inflammatory markers and disease severity in COVID-19 for predicting disease prognosis. Methods Patients with COVID-19 who had confirmed diagnosis with SARS-CoV-2 nucleic acid RT-PCR were enrolled into the study. Data on demographic and clinical characteristics, and laboratory values of CRP, ferritin, d-dimer and procalcitonin were measured on admission. Patients were followed up prospectively with a standardized approach until hospital discharge or death. Individuals were classified as asymptomatic, mild and severe pneumonia according to their clinical, laboratory and radiological characteristics. Worse outcome was defined as requirement of intensive care unit (ICU) admission or death. Blood samples were collected at enrollment and serum levels of IL-6 and IL-18 were determined by ELISA. Association between IL-18 and other inflammatory markers and prognosis were analyzed. Results There were 58 COVID-19 patients (50% male) with a median age of 43 (min 22-max 81) years. Twenty age and sex matched healthy subjects were served as control group. The study population was divided into three groups according to disease severity: asymptomatic (n = 20), mild pneumonia group (n = 27) and a severe group (n = 11). During follow up nine (15.5%) patients required ICU admission and three of them were died eventually. Serum IL-18 were correlated with other inflammatory markers and biochemical markers of organ injury; creatinine, liver enzymes and troponin. Serum IL-18 levels were remarkably higher in COVID-19 patients compared to healthy subjects with being highest in severe pneumonia group (p
- Published
- 2020