Ağır COVID-19 Hastalarında Serum IL-33 Düzeylerinin Pulmoner Fibrozis ile İlişkisinin Değerlendirilmesi

Year 2023, Volume: 6 Issue: 1, 1 - 13, 19.06.2023

Çiğdem Damla DENİZ Fatih YÜCEL Hasan ŞENAY Fatma KACAR Mehmet Sinan İYİSOY Nahide BARAN Betül KOZANHAN Mehmet ERYILMAZ Mehmet KOC

Abstract

Bu çalışmanın amacı, COVID-19 tanısı alarak, takip edilen hastalarda, pulmoner fibrozis gelişiminde IL-33’ün prediktif değerini araştırmaktır. Çalışmamız Konya Eğitim ve Araştırma Hastanesi, Yoğun Bakım Ünitesinde takip edilmiş COVID-19 kesin tanılı hastalar üzerinde yapılmıştır. IL-33 konsantrasyonlarını ölçmek için ELISA yöntemi kullanılmıştır. Hastaların, beyaz kan hücresi (WBC), hemoglobin değeri, trombosit (PLT) ve lenfosit (LNF) sayıları; D-dimer ve fibrinojen gibi koagülasyon ile ilişkili parametreleri; C-reaktif protein (CRP), albümin (Alb), ürik asit, ferritin (FER) ve arter kan gazlarından laktat ve pO2 sonuçları çalışmaya dahil edilmiştir. Sitokin düzeyleri ile klinik, biyokimyasal, radyografik verilerin korelasyonları analiz edilmiştir. Şiddetli hastalığı olan COVID-19 hastalarında önemli ölçüde daha yüksek serum IL-33 konsantrasyonu olduğu bulunmuştur. IL-33'ün serum değerleri ile CRP, CRP/Alb oranı ve ürik asit arasında orta düzeyde pozitif korelasyon saptanmıştır. Subplevral bant varlığında IL-33 düzeylerinin anlamlı düzeyde yüksek, FER ve PLT düzeylerinin anlamlı düzeyde düşük olduğu görülmüştür. Fibrotik şerit varlığında IL-33 düzeylerinin anlamlı düzeyde yüksek; WBC, PLT ve PLT/LNF oranının anlamlı düzeyde düşük olduğu görülmüştür. ROC analizi sonuçlarına göre IL-33 için sensitivite %97, spesifisite %86 ve AUC değeri 1,97 olarak bulunmuştur. IL-33, COVID-19'un bazı radyolojik ve laboratuvar parametreleriyle ilişkili ve COVID-19'da umut verici bir belirteç olarak belirlendiği için terapötik bir hedefi temsil edebilir.

Keywords

COVID-19, IL-33, akciğer fibrozisi, prognoz, ROC

Supporting Institution

Konya Eğitim ve Araştırma Hastanesi, Tıpta Uzmanlık Eğitim Kurulu

Thanks

Bu çalışmaya destek ve katkılarından dolayı Konya Eğitim ve Araştırma Hastanesi, Tıpta Uzmanlık Eğitim Kurulu'na teşekkür ederiz.

Evaluation of The Relationship Between Serum IL-33 Levels and Pulmonary Fibrosis in Severe COVID-19 Patients

Abstract

The aim of this study is to investigate the predictive value of IL-33 in the development of pulmonary fibrosis in patients diagnosed with COVID-19 and followed up. Our study was carried out on patients with a definitive diagnosis of COVID-19 who were followed up in the Intensive Care Unit of Konya Training and Research Hospital. ELISA method was used to measure IL-33 concentrations. White blood cell (WBC), hemoglobin value, platelet (PLT) and lymphocyte (LNF) counts of the patients; coagulation-related parameters such as D-dimer and fibrinogen; C-reactive protein (CRP), albumin (Alb), uric acid, ferritin (FER) and lactate and pO2 results from arterial blood gases were included in the study. Correlations of cytokine levels with clinical, biochemical and radiographic data were analyzed. We found that COVID-19 patients with severe disease had a significantly higher serum IL-33 concentration. A moderate positive correlation was found between serum values of IL-33 and CRP, CRP/Alb ratio and uric acid. In the presence of subpleural band, IL-33 levels were found to be significantly higher, and FER and PLT levels were significantly lower. In the presence of fibrotic stripe, IL-33 levels were significantly higher; WBC, PLT and PLT/LNF ratios were found to be significantly lower. According to the results of the ROC analysis, the sensitivity for IL-33 was 97%, the specificity was 86%, and the AUC value was 1.97. IL-33 is associated with some radiological and laboratory parameters of COVID-19 and is a promising marker in COVID-19 and may also represent a therapeutic target.

Keywords

COVID-19, IL-33, ROC, lung fibrosis, prognosis

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