Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients |
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| Authors: | Nikolaos K. Gatselis Vasiliki Lygoura Aggeliki Lyberopoulou George Giannoulis Anna Samakidou Antonia Vaiou George Vatidis Katerina Antoniou Aggelos Stefos Sarah Georgiadou Dimitrios Sagris Dafni Sveroni Despoina Stergioula Stella Gabeta George Ntaios George N. Dalekos |
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| Affiliation: | Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), General University Hospital of Larissa, 41110 Larissa, Greece; (V.L.); (A.L.); (G.G.); (A.S.); (A.V.); (G.V.); (K.A.); (A.S.); (S.G.); (D.S.); (D.S.); (D.S.); (S.G.); (G.N.); (G.N.D.) |
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| Abstract: | 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. |
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| Keywords: | biomarker coronavirus disease-19 soluble interleukin-2 receptor |
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