Predictive Role of CX3CL1 and D-dimer Levels in Mortality Risk Stratification for COPD Patients With COVID-19

CX3CL1和D-二聚体水平在慢性阻塞性肺病合并新冠肺炎患者死亡风险分层中的预测作用

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Abstract

OBJECTIVE: In this retrospective study conducted at Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University (Yulin, SN, CHN), we aimed to investigate the predictive role of CX3CL1 and D-dimer for mortality in hospitalized chronic obstructive pulmonary disease (COPD) patients with COVID-19. METHODS: Complete blood counts and inflammatory cytokine levels were collected at admission from hospitalized COPD patients with COVID-19 to explore the relationship between inflammatory parameters and mortality of COPD patients with COVID-19. RESULTS: Compared to severe COPD with COVID-19 patients, circulating biomarkers of CX3CL1 (453.3 vs. 305.3 pg/mL, p<0.01) and D-dimer (1231.8 ng/mL vs. 680 ng/mL, p<0.01) were significantly elevated in critical illness participants. The C indices of inflammatory biomarkers CX3CL1 and D-dimer were 0.78 and 0.68, respectively. Furthermore, the prolonged illness of COPD patients with COVID-19 was associated with circulating inflammatory biomarkers of CX3CL1 (p=0.021) and D-dimer (p=0.041). CONCLUSION: Circulating inflammatory biomarkers of CX3CL1 and D-dimer have shown the potential to predict mortality among COPD patients with severe COVID-19. Monitoring CX3CL1 and D-dimer levels could enhance clinical decision-making and risk stratification, potentially guiding more effective treatment strategies to improve patient outcomes.

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