Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia
Background: Cytokine dysregulation in COVID-19 patients aged over 60 has been associated to adverse outcomes. While serum levels have been studied, cellular expression, particularly in Afro-Colombians, remains understudied. This research aims to describe cytokine expression in peripheral blood leuko...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S240584402405059X |
| _version_ | 1797221791543853056 |
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| author | Remberto Ramos-González Eder Cano-Pérez Steev Loyola Rita Sierra-Merlano Doris Gómez-Camargo |
| author_facet | Remberto Ramos-González Eder Cano-Pérez Steev Loyola Rita Sierra-Merlano Doris Gómez-Camargo |
| author_sort | Remberto Ramos-González |
| collection | DOAJ |
| description | Background: Cytokine dysregulation in COVID-19 patients aged over 60 has been associated to adverse outcomes. While serum levels have been studied, cellular expression, particularly in Afro-Colombians, remains understudied. This research aims to describe cytokine expression in peripheral blood leukocytes and its association with adverse outcomes in COVID-19 patients aged over 60 at Cartagena's referral hospital. Methods: A cohort study was conducted, encompassing severe and critical cases of COVID-19 between November 2021 and February 2022. At baseline, the cellular expression level of cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ was assessed using flow cytometry. Additionally, various biochemical, hematological, and coagulation markers were evaluated. The main outcome was time to death. Results: Among the 50 enrolled participants, the median age was 76.5 years, 60% were male, 60% were admitted to the ICU, and 42% died. Lactate dehydrogenase and hemoglobin were the only markers that differed between fatal and surviving cases. Regarding cytokines, the level of IL-6 expression was associated with an increased risk of death. Specifically, a one percent increase in the expression was associated with a 7.3% increase in the risk of death. Stratifying the analysis by death and ICU admission, the median expression level remained high in fatal cases who were admitted to the ICU. Conclusions: Our findings revealed a significant association between high cellular expression levels of IL-6 and an increased risk of mortality. These results provide valuable scientific insights that could inform the prioritization of case management, providing especially advantageous for the vulnerable Afro-Colombian group. |
| first_indexed | 2024-04-24T13:11:03Z |
| format | Article |
| id | doaj.art-d1f937b2b6714691917b5faf8c68596f |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T13:11:03Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-d1f937b2b6714691917b5faf8c68596f2024-04-05T04:41:20ZengElsevierHeliyon2405-84402024-04-01107e29028Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, ColombiaRemberto Ramos-González0Eder Cano-Pérez1Steev Loyola2Rita Sierra-Merlano3Doris Gómez-Camargo4Departamento de Medicina Interna, Facultad de Medicina, Universidad de Cartagena, Cartagena, ColombiaGrupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena, ColombiaGrupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, PeruDepartamento de Medicina Interna, Facultad de Medicina, Universidad de Cartagena, Cartagena, ColombiaGrupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia; Corresponding author. Cra. 50 #24120, Cartagena de Indias, 130014, Colombia.Background: Cytokine dysregulation in COVID-19 patients aged over 60 has been associated to adverse outcomes. While serum levels have been studied, cellular expression, particularly in Afro-Colombians, remains understudied. This research aims to describe cytokine expression in peripheral blood leukocytes and its association with adverse outcomes in COVID-19 patients aged over 60 at Cartagena's referral hospital. Methods: A cohort study was conducted, encompassing severe and critical cases of COVID-19 between November 2021 and February 2022. At baseline, the cellular expression level of cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ was assessed using flow cytometry. Additionally, various biochemical, hematological, and coagulation markers were evaluated. The main outcome was time to death. Results: Among the 50 enrolled participants, the median age was 76.5 years, 60% were male, 60% were admitted to the ICU, and 42% died. Lactate dehydrogenase and hemoglobin were the only markers that differed between fatal and surviving cases. Regarding cytokines, the level of IL-6 expression was associated with an increased risk of death. Specifically, a one percent increase in the expression was associated with a 7.3% increase in the risk of death. Stratifying the analysis by death and ICU admission, the median expression level remained high in fatal cases who were admitted to the ICU. Conclusions: Our findings revealed a significant association between high cellular expression levels of IL-6 and an increased risk of mortality. These results provide valuable scientific insights that could inform the prioritization of case management, providing especially advantageous for the vulnerable Afro-Colombian group.http://www.sciencedirect.com/science/article/pii/S240584402405059XCytokinesCOVID-19DeathPrognosisIntensive care unit |
| spellingShingle | Remberto Ramos-González Eder Cano-Pérez Steev Loyola Rita Sierra-Merlano Doris Gómez-Camargo Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia Heliyon Cytokines COVID-19 Death Prognosis Intensive care unit |
| title | Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia |
| title_full | Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia |
| title_fullStr | Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia |
| title_full_unstemmed | Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia |
| title_short | Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia |
| title_sort | cytokine expression and mortality risk among covid 19 hospitalized patients over 60 years of age in a referral hospital in cartagena colombia |
| topic | Cytokines COVID-19 Death Prognosis Intensive care unit |
| url | http://www.sciencedirect.com/science/article/pii/S240584402405059X |
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