TY - JOUR
T1 - High mobility group box 1 and interleukin 6 at intensive care unit admission as biomarkers in critically Ill COVID-19 Patients
AU - Sivakorn, Chaisith
AU - Dechsanga, Jutamas
AU - Jamjumrus, Lawan
AU - Boonnak, Kobporn
AU - Schultz, Marcus J.
AU - Dondorp, Arjen M.
AU - Phumratanaprapin, Weerapong
AU - Ratanarat, Ranistha
AU - Naorungroj, Thummaporn
AU - Wattanawinitchai, Patchrapa
AU - Siripoon, Tanaya
AU - Duangdee, Chatnapa
AU - Techarang, Tachpon
N1 - Funding Information: We thank all patients, staffs and medical technologists of Chonburi Hospital (Chonburi Province, Thailand) and Buddhasothorn Hospital (Chachoengsao Province, Thailand). The American Society of Tropical Medicine and Hygiene has waived the Open Access fee for this article due to the ongoing COVID-19 pandemic. The publication of this work was granted by Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Publisher Copyright: Copyright © 2021 by The American Society of Tropical Medicine and Hygiene
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Exuberant inflammation manifesting as a “cytokine storm” has been suggested as a central feature in the pathogenesis of severe coronavirus disease 2019 (COVID-19). This study investigated two prognostic biomarkers, the high mobility group box 1 (HMGB1) and interleukin-6 (IL-6), in patients with severe COVID-19 at the time of admission in the intensive care unit (ICU). Of 60 ICU patients with COVID-19 enrolled and analyzed in this prospective cohort study, 48 patients (80%) were alive at ICU discharge. HMGB1 and IL-6 plasma levels at ICU admission were elevated compared with a healthy control, both in ICU nonsurvivors and ICU survivors. HMGB1 and IL-6 plasma levels were higher in patients with a higher Sequential Organ Failure Assessment (SOFA) score (> 10), and the presence of septic shock or acute kidney injury. HMGB1 and IL-6 plasma levels were also higher in patients with a poor oxygenation status (PaO2/FiO2 < 150 mm Hg) and a longer duration of ventilation (> 7 days). Plasma HMGB1 and IL-6 levels at ICU admission also correlated with other prognostic markers, including the maximum neutrophil/lymphocyte ratio, D-dimer levels, and C-reactive protein levels. Plasma HMGB1 and IL-6 levels at ICU admission predicted ICU mortality with comparable accuracy to the SOFA score and the COVID-GRAM risk score. Higher HMGB1 and IL-6 were not independently associated with ICU mortality after adjustment for age, gender, and comorbidities in multivariate analysis models. In conclusion, plasma HMGB1 and IL6 at ICU admission may serve as prognostic biomarkers in critically ill COVID-19 patients.
AB - Exuberant inflammation manifesting as a “cytokine storm” has been suggested as a central feature in the pathogenesis of severe coronavirus disease 2019 (COVID-19). This study investigated two prognostic biomarkers, the high mobility group box 1 (HMGB1) and interleukin-6 (IL-6), in patients with severe COVID-19 at the time of admission in the intensive care unit (ICU). Of 60 ICU patients with COVID-19 enrolled and analyzed in this prospective cohort study, 48 patients (80%) were alive at ICU discharge. HMGB1 and IL-6 plasma levels at ICU admission were elevated compared with a healthy control, both in ICU nonsurvivors and ICU survivors. HMGB1 and IL-6 plasma levels were higher in patients with a higher Sequential Organ Failure Assessment (SOFA) score (> 10), and the presence of septic shock or acute kidney injury. HMGB1 and IL-6 plasma levels were also higher in patients with a poor oxygenation status (PaO2/FiO2 < 150 mm Hg) and a longer duration of ventilation (> 7 days). Plasma HMGB1 and IL-6 levels at ICU admission also correlated with other prognostic markers, including the maximum neutrophil/lymphocyte ratio, D-dimer levels, and C-reactive protein levels. Plasma HMGB1 and IL-6 levels at ICU admission predicted ICU mortality with comparable accuracy to the SOFA score and the COVID-GRAM risk score. Higher HMGB1 and IL-6 were not independently associated with ICU mortality after adjustment for age, gender, and comorbidities in multivariate analysis models. In conclusion, plasma HMGB1 and IL6 at ICU admission may serve as prognostic biomarkers in critically ill COVID-19 patients.
UR - http://www.scopus.com/inward/record.url?scp=85109727077&partnerID=8YFLogxK
U2 - https://doi.org/10.4269/ajtmh.21-0165
DO - https://doi.org/10.4269/ajtmh.21-0165
M3 - Article
C2 - 33939645
SN - 0002-9637
VL - 105
SP - 73
EP - 80
JO - American journal of tropical medicine and hygiene
JF - American journal of tropical medicine and hygiene
IS - 1
ER -