Journal Article

Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients

Vaiou, Antonia, Lygoura, Vasiliki, Stergioula, Despoina, Gatselis, Nikolaos K., Stefos, Aggelos, Ntaios, George, Gabeta, Stella, Lyberopoulou, Aggeliki, Samakidou, Anna, Vatidis, George, Georgiadou, Sarah, Sagris, Dimitrios, Dalekos, George N., Sveroni, Dafni, Antoniou, Katerina, Giannoulis, George

2022

Overview

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.

• Publisher: MDPI AG,MDPI
• Subject: Age / biomarker / Biomarkers / Body mass index / Cardiovascular disease / Chronic obstructive pulmonary disease / coronavirus disease-19 / Coronaviruses / Corticosteroids / COVID-19 / COVID-19 - metabolism / COVID-19 - pathology / Cytokines / Diabetes / Female / Hospitalization / Humans / Immunology / Immunotherapy / Interleukin 1 receptor antagonist / Interleukin 2 / Interleukin 2 receptors / Intravenous administration / Intubation / Laboratories / Lymphocytes / Male / Middle Aged / Monoclonal antibodies / Mortality / Patients / Pneumonia / Predictive Value of Tests / Receptors, Interleukin-2 - blood / Receptors, Interleukin-2 - metabolism / Respiratory failure / Respiratory Insufficiency - diagnosis / Respiratory Insufficiency - metabolism / Risk factors / Severe acute respiratory syndrome coronavirus 2 / soluble interleukin-2 receptor