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Interleukin-21: a potential biomarker for diagnosis and predicting prognosis in COVID-19 patients
Acet Öztürk, Nilüfer Aylin; Ursavas, Ahmet; Dilektasli, Asli Görek; Demirdögen, Ezgi; Coskun, Necmiye Funda; Ediger, Dane; Uzaslan, Ayse Esra; Yöyen Ermis, Digdem; Karaca, Mert; Terzi, Orkun Eray; Bayram, Merve; Ömer Topçu, Dilara; Yigitliler, Büsra; Yurttas, Ahmet; Maharramov, Shahriyar; Yazici, Gamze; Oral, Haluk Barbaros; Karadag, Mehmet.
  • Acet Öztürk NA; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Ursavas A; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Dilektasli AG; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Demirdögen E; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Coskun NF; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Ediger D; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Uzaslan AE; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Yöyen Ermis D; Department of Immunology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Karaca M; Department of Immunology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Terzi OE; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Bayram M; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Ömer Topçu D; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Yigitliler B; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Yurttas A; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Maharramov S; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Yazici G; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Oral HB; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
  • Karadag M; Department of Pulmonology, Faculty of Medicine, Uludag University, Bursa, Turkey.
Turk J Med Sci ; 51(5): 2274-2284, 2021 10 21.
Article in English | MEDLINE | ID: covidwho-1566690
ABSTRACT
Background/

aim:

COVID-19 patients have a wide spectrum of disease severity. Several biomarkers were evaluated as predictors for progression towards severe disease. IL-21 is a member of common γ-chain cytokine family and creates some specific effects during programming and maintenance of antiviral immunity. We aimed to assess IL-21 as a biomarker for diagnosis and outcome prediction in patients hospitalized with COVID-19. Materials and

methods:

Patients with a preliminary diagnosis of COVID-19 and pneumonia other than COVID-19 admitted to a tertiary care hospital were included consecutively in this comparative study.

Results:

The study population consisted of 51 patients with COVID-19 and 11 patients with non-COVID-19 pneumonia. Serum IL-21 concentration was markedly higher, and serum CRP concentration was significantly lower in COVID-19 patients compared to non-COVID-19 pneumonia patients. Within COVID-19 patients, 10 patients showed radiological and clinical progression. Patients with clinical worsening had lower lymphocyte count and haemoglobin. In addition to that, deteriorating patients had higher urea, LDH levels, and elevated concentration of both IL-6 and IL-21. The cut-off value of 106 ng/L for IL-21 has 80.0% sensitivity, %60.9 specificity for discriminating patients with clinical worsening. Multivariable analysis performed to define risk factors for disease progression identified IL-6 and IL-21 as independent predictors. Odds ratio for serum IL-6 concentrations ≥ 3.2 pg/mL was 8.07 (95% CI 1.37-47.50, p = 0.04) and odds ratio for serum IL-21 concentrations ≥ 106 ng/L was 6.24 (95% CI 1.04 ­ 37.3, p = 0.02).

Conclusion:

We identified specific differences in serum IL-21 between COVID-19 and non-COVID-19 pneumonia patients. Serum IL-21 measurement has promising predictive value for disease progression in COVID-19 patients. High serum IL-6 and IL-21 levels obtained upon admission are independent risk factors for clinical worsening.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Interleukins / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Turk J Med Sci Year: 2021 Document Type: Article Affiliation country: SAG-2102-24

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Interleukins / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Turk J Med Sci Year: 2021 Document Type: Article Affiliation country: SAG-2102-24