Inflammatory-Related Clinical and Metabolic Outcomes in COVID-19 Patients

Abstract

Background. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) infection elicits inflammatory manifestations that relate with a “cytokine storm.” Objective. The aim of this research was to assess the role of circulating interleukin 6 (IL-6) levels and other inflammatory markers in patients with coronavirus disease 2019 (COVID-19) on metabolic functions and accompanying clinical complications. Patients and Methods. A total of 165 patients diagnosed with COVID-19 pneumonia were examined for medical features and inflammatory markers such as blood IL-6, CRP, ferritin, LDH, neutrophil/lymphocyte index (NLI), D-Dimer, and Red Cell Distribution Width (RDW). Regression analyses concerning electronically collected medical data were adjusted by appropriate factors and confounding variables. Results. Plasma IL-6 determinations evidenced a consistent association with hospital stay days, Intensive Care Unit (ICU) admission, and mortality rates. Similar trends were found for other proinflammatory variables, where ferritin and NLI showed a remarkable value as surrogates. Hyperglycaemia and the Charlson Comorbidity Index Score were positively associated with the inflammatory response induced by the SARS-COV-2 infection. An unhealthy lifestyle such as smoking and alcoholic drinks consumption as well as excessive body adiposity influenced inflammatory-related outcomes in the screened patients. Conclusion. IL-6 together with other inflammatory biomarkers accompanied poor clinical and metabolic outcomes in COVID-19-infected patients. IL-6 may result in a suitable proxy to individually categorise patients in order to manage this infectious pandemic.

Proinflammatory and Hepatic Features Related to Morbidity and Fatal Outcomes in COVID-19 Patients

“…Until now, certain clinical, demographic, and phenotypical factors have been reported to be associated with the evolution and severity of COVID-19, encompassing age, sex, ethnicity, underlying medical conditions such as obesity, diabetes, and hypertension, poverty and crowding, pregnancy, and the use of certain medications and genetics [ 6 , 7 ]. Others include elevated levels of proinflammatory cytokines, liver enzymes, coagulation factors, body temperature, and unhealthy lifestyle such as smoking and alcoholic drinks consumption [ 8 ]. Nonetheless, there is a constant need for the search for easily accessible, rapid and accurate markers related to the course of COVID-19, which could contribute to improving the individualized clinical management and monitoring of the progression of this infection through an integrative precision medicine approach [ 9 ].…”

Evolution of patients infected with SARS-CoV-2 according to previous metabolic status

“…La suma de fenómenos inflamatorios, en concreto la liberación de citoquinas en la patogenia de la propia infección por SARS-CoV-2 y la preexistente en estos pacientes por exceso de peso de forma mantenida, conlleva un daño endotelial con una respuesta inmune ineficaz por parte del huésped y una consecuente peor evolución de la enfermedad. Ambos cuadros se han relacionado con elevados niveles séricos de clásicos marcadores de inflamación como son la IL-6, la proteína C-reactiva o la ferritina (22). Además, la obesidad implica habitualmente una función respiratoria reducida, habiéndose descrito un volumen de reserva, una capacidad funcional y una distensibilidad pulmonar menores, complicando la aplicación de técnicas de soporte ventilatorio en estos casos (23).…”

Does COVID-19 Cause New-Onset Diabetes or Unmask Pre-Existing Diabetes?

“…Thus, in the prospective Women's Health Study, elevated levels of CRP and IL-6 predict the development of type 2 diabetes over a 4-year follow-up [14]. In the retrospective study of Martinez et al [15] of 165 patients admitted for COVID-19 pneumonia, hyperglycemia was positively associated with the proinflammatory markers CRP and ferritin. Furthermore, Zhu et al [16] compared levels of several pro-inflammatory markers between 2 groups of admitted COVID-19 patients: one group with well-controlled diabetes (n = 282) (median blood glucose 6.4 mmol/L, inter-quartile range 5.2-7.5) and the second groups with poorly controlled diabetes (n = 528) (median blood glucose 10.9 mmol/L, inter-quartile range 7.6-14.3).…”