sIL-2R and sIL-2R/lymphocyte ratio as indicators of severity in COVID-19 pediatric patients | ||||
| Microbes and Infectious Diseases | ||||
| Article 8, Volume 3, Issue 4, November 2022, Page 814-829 PDF (642.19 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mid.2022.156894.1369 | ||||
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| Authors | ||||
Nourhan Abdelfattah1; Maha Fathy2; Heba Ali3; Walaa Khater   4
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| 1Medical Microbiology and Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| 2Medical Microbiology and Immunology Department, Faculty of Medicine, Ain Shams University | ||||
| 3Department of Pediatrics, Pulmonology division, Ain Shams University Children's Hospital, Faculty of Medicine, Cairo, Egypt | ||||
| 4Medical microbiology and immunology faculty of medicine Ain Shams University | ||||
| Abstract | ||||
| Objectives: To determine the role of sIL-2R and sIL-2R/lymphocyte ratio as indicators of COVID-19 severity and predictors of clinical progression among children and adolescents. Patients and Methods: This observational cross-sectional study enrolled 76 pediatric patients [40 (52.6%) males and 36 (47.4%) females] with confirmed COVID-19. Patients were classified into two groups; mild to moderate and severe to critical according to WHO classification of severity and were assessed using COVID‑19 severity assessment score and COVID-19 severity index. Soluble IL-2R (sIL-2R) concentrations were measured using a commercial enzyme-linked immunosorbent assay and sIL-2R/lymphocyte ratio was calculated for each patient. Results: Receiver-operating characteristic (ROC) curve analysis showed that sIL-2R has a significantly higher discriminative power between patients in both groups (AUC=0.955) as compared to sIL-2R/lymphocyte ratio (AUC=0.711) (p < /em> value<0.0001). At an associated criterion of >140 ng/l, the sensitivity and specificity of sIL-2R were 81.4.% and 100%, respectively. Soluble IL-2R also showed better performance in predicting the need for supplemental oxygen [threshold>140 ng/l, AUC=0.904 (0.814 to 0.960)], ICU admission [threshold>140 ng/l, AUC=0. 935 (0.854 to 0.979)], and mechanical ventilation [threshold>180 ng/l, AUC=0. 892 (0.799 to 0.951)]. Conclusion: Soluble IL-2R can play a potential role as a feasible indicator of COVID-19 severity in children and adolescents, thus informing healthcare providers to direct care to patients who may require intensive or critical care. | ||||
| Keywords | ||||
| sIL-2R/lymphocyte ratio; SARS-CoV-2; children; clinical progression; cytokines | ||||
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