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10.1172/jci.insight.139024

http://scihub22266oqcxt.onion/10.1172/jci.insight.139024
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suck abstract from ncbi


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pmid32544099      JCI+Insight 2020 ; 5 (13): ä
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  • IL-6 and CD8+ T cell counts combined are an early predictor of in-hospital mortality of patients with COVID-19 #MMPMID32544099
  • Luo M; Liu J; Jiang W; Yue S; Liu H; Wei S
  • JCI Insight 2020[Jul]; 5 (13): ä PMID32544099show ga
  • BACKGROUNDFatal cases of COVID-19 are increasing globally. We retrospectively investigated the potential of immunologic parameters as early predictors of COVID-19.METHODSA total of 1018 patients with confirmed COVID-19 were enrolled in our 2-center retrospective study. Clinical feature, laboratory test, immunological test, radiological findings, and outcomes data were collected. Univariate and multivariable logistic regression analyses were performed to evaluate factors associated with in-hospital mortality. Receiver operator characteristic (ROC) curves and survival curves were plotted to evaluate their clinical utility.RESULTSThe counts of all T lymphocyte subsets were markedly lower in nonsurvivors than in survivors, especially CD8+ T cells. Among all tested cytokines, IL-6 was elevated most significantly, with an upward trend of more than 10-fold. Using multivariate logistic regression analysis, IL-6 levels of more than 20 pg/mL and CD8+ T cell counts of less than 165 cells/muL were found to be associated with in-hospital mortality after adjusting for confounding factors. Groups with IL-6 levels of more than 20 pg/mL and CD8+ T cell counts of less than 165 cells/muL had a higher percentage of older and male patients as well as a higher proportion of patients with comorbidities, ventilation, intensive care unit admission, shock, and death. Furthermore, the receiver operating curve of the model combining IL-6 (>20 pg/mL) and CD8+ T cell counts (<165 cells/muL) displayed a more favorable discrimination than that of the CURB-65 score. The Hosmer-Lemeshow test showed a good fit of the model, with no statistical significance.CONCLUSIONIL-6 (>20 pg/mL) and CD8+ T cell counts (<165 cells/muL) are 2 reliable prognostic indicators that accurately stratify patients into risk categories and predict COVID-19 mortality.FundingThis work was supported by funding from the National Natural Science Foundation of China (no. 81772477 and 81201848).
  • |*CD8-Positive T-Lymphocytes[MESH]
  • |*Hospital Mortality[MESH]
  • |Aged[MESH]
  • |Area Under Curve[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/blood/*immunology/mortality[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Interleukin-10/immunology[MESH]
  • |Interleukin-6/*immunology[MESH]
  • |Interleukin-8/immunology[MESH]
  • |Logistic Models[MESH]
  • |Lymphocyte Count[MESH]
  • |Lymphopenia/blood/epidemiology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Multivariate Analysis[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/blood/*immunology/mortality[MESH]
  • |Prognosis[MESH]
  • |ROC Curve[MESH]
  • |Receptors, Interleukin-2/immunology[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]


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