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High Mobility Group Box 1 and Interleukin 6 at Intensive Care Unit Admission as Biomarkers in Critically Ill COVID-19 Patients.
Sivakorn, Chaisith; Dechsanga, Jutamas; Jamjumrus, Lawan; Boonnak, Kobporn; Schultz, Marcus J; Dondorp, Arjen M; Phumratanaprapin, Weerapong; Ratanarat, Ranistha; Naorungroj, Thummaporn; Wattanawinitchai, Patchrapa; Siripoon, Tanaya; Duangdee, Chatnapa; Techarang, Tachpon.
Affiliation
  • Sivakorn C; 1Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Dechsanga J; 2Division of Pulmonary and Critical Care, Department of Medicine, Chonburi Hospital, Chonburi, Thailand.
  • Jamjumrus L; 3Division of Pulmonary and Critical Care, Department of Medicine, Buddhasothorn Hospital, Chachoengsao, Thailand.
  • Boonnak K; 4Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Schultz MJ; 5Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Dondorp AM; 6Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  • Phumratanaprapin W; 7Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom.
  • Ratanarat R; 5Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Naorungroj T; 6Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  • Wattanawinitchai P; 7Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom.
  • Siripoon T; 1Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Duangdee C; 8Siriraj Hospital, Division of Critical Care, Department of Medicine, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
  • Techarang T; 8Siriraj Hospital, Division of Critical Care, Department of Medicine, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
Am J Trop Med Hyg ; 105(1): 73-80, 2021 05 03.
Article in En | MEDLINE | ID: mdl-33939645
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.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Interleukin-6 / Critical Illness / HMGB1 Protein / SARS-CoV-2 / COVID-19 Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Trop Med Hyg Year: 2021 Document type: Article Affiliation country: Tailandia Country of publication: Estados Unidos

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Interleukin-6 / Critical Illness / HMGB1 Protein / SARS-CoV-2 / COVID-19 Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Am J Trop Med Hyg Year: 2021 Document type: Article Affiliation country: Tailandia Country of publication: Estados Unidos