Serum chemokine CC‐motif ligand 17 is a predictive marker of severe COVID‐19 in haemodialysis patients: A retrospective observational study

Abstract

Background: Maintenance haemodialysis (HD) patients are at higher risk for severe coronavirus disease 2019 . Because of a limited number of facilities that can provide inpatient treatment for COVID-19 and HD, it is important to identify HD patients who are at high risk for severe COVID-19. For mild to moderate COVID-19 patients, chemokine CC-motif ligand 17 (CCL17) was reported to be a predictive marker for severe COVID-19; however, the validity of CCL17 among HD patients is unknown.Methods: This retrospective observational study enrolled 107 HD patients with mild or moderate COVID-19 at hospitalization (mean age 70.1 ± 15.1 years; 71.0% male).Receiver operating characteristic and logistic regression analyses were used to examine the predictive validity of indices for severe COVID-19.Results: During hospitalization, 32 patients developed severe COVID-19. Serum CCL17 collected at admission exhibited a higher area under the curve value (0.818) compared with that of other indicators including lactate dehydrogenase and C-reactive protein for the prediction of severe COVID-19. The optimal cut-off value for CCL17 was 150.5 pg/mL. A multi-variate logistic analysis revealed that CCL17 (above 150.5 pg/mL) was significantly associated with severe COVID-19 (Odds ratio, 0.063; 95% Confidence interval [CI], 0.017-0.227; p < .001) even after adjustment for covariates. The addition of the CCL17 to a model consisting of vaccination status, albumin, blood urea nitrogen, C-reacting protein and lactate dehydrogenase significantly improved classification performance for severe COVID-19 using the net reclassification (1.16, 95% CI: 0.82-1.50, p < .001) and integrated discrimination (0.18, 95% CI: 0.09-0.26, p < .001) improvement.Conclusion: CCL17 levels in HD patients with mild or moderate COVID-19 predict risk of developing severe COVID-19.

Risk factors and prognosis for coronavirus disease 2019 among 131 hemodialysis patients during the Omicron variant epidemic

“…In our study, non-survivors exhibited significantly higher PCT and IL-6 levels than survivors. It is proposed that another inflammatory factor–serum chemokine CC-motif ligand 17, is a good predictive marker of severe COVID-19 in hemodialysis patients [ 8 , 20 ]. Monitoring inflammation markers to better recognize patients at high risk for death, especially those with minor presentations, is necessary for treating COVID-19.…”