Th1/Th2/Th17 Cytokines as Mortality Predictors in Older Adults With COVID-19 Pneumonia
| Author | Huijun Mu | en |
| Author | Ying Yin | en |
| Author | Haiping Zhang | en |
| Orcid | Huijun Mu [0000-0003-4352-2506] | en |
| Orcid | Ying Yin [0000-0002-8367-1103] | en |
| Orcid | Haiping Zhang [0000-0002-3841-5856] | en |
| Issued Date | 2026-05-31 | en |
| Abstract | Background: Dysregulated cytokine responses play a critical role in the pathogenesis of COVID-19; however, the age-specific dynamics of Th1/Th2/Th17 responses and their interactions with bacterial co-infections in older adults with COVID-19 pneumonia remain poorly understood. Objectives: This study examined Th1/Th2/Th17 cytokine profiles (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, IL-17A) in hospitalized older adults with COVID-19 pneumonia, assessed their association with mortality, and further evaluated their independent prognostic value. Methods: A total of 231 hospitalized patients aged 60 years and older were enrolled in this retrospective study. Retrospective data were collected to assess age-related differences, disease progression, the impact of bacterial co-infections, and mortality rates. Stepwise logistic regression was used to identify key confounding factors, and multivariable models were used to evaluate independent prognostic indicators. Results: IL-6 levels were significantly higher in the 80 - 89 age group than in the 60 - 69 and 70 - 79 age groups (P = 0.002 and P = 0.009). IL-6 peaked within the first three days after symptom onset and remained elevated throughout the course of the illness. IL-10 levels were higher during days 1 - 9 than during days 10 - 18 (P = 0.006). SARS-CoV-2 RNA-positive (S-RNA+) patients had higher IL-6 and IL-10 levels than RNA-negative (S-RNA-) cases (P = 0.007, P = 0.03). Among S-RNA⁺ patients, those with bacterial co-infection (S-RNA+BI) showed further elevations in IL-6 (P = 0.03). The three groups showed significant differences in mortality (P < 0.001), with the highest rate in the S-RNA+BI group. In non-survivors, elevated IL-4, IL-6, and IL-10 were observed in the S-RNA+BI subgroup, whereas only IL-6 and IL-10 were elevated in the S-RNA+ subgroup. ROC analysis identified the optimal cut-off values of these cytokines for predicting mortality. After adjustment for CURB-65 in logistic regression, only IL-6 independently predicted mortality, whereas IL-4 and IL-10 were only associated with disease severity. Conclusions: Univariate analysis indicated that IL-4, IL-6, and IL-10 were correlated with mortality in older adult patients with COVID-19 pneumonia, particularly those with bacterial co-infections. After adjustment for disease severity, only IL-6 retained independent prognostic value for mortality. | en |
| DOI | https://doi.org/10.5812/jjm-171273 | en |
| URI | https://brieflands.com/journals/jjm/articles/171273 | en |
| Keyword | Coronavirus Disease 2019 (COVID-19) | en |
| Keyword | Coronavirus | en |
| Keyword | Dialysis | en |
| Keyword | Financial Burden | en |
| Keyword | Safety | en |
| Keyword | Immune System | en |
| Keyword | Stroke | en |
| Keyword | Mortality | en |
| Keyword | Bacterial Co-infection | en |
| Keyword | Sense Of Belonging | en |
| Keyword | Social Support | en |
| Keyword | Neighborhood | en |
| Keyword | Older Adults | en |
| Publisher | Brieflands | en |
| Title | Th1/Th2/Th17 Cytokines as Mortality Predictors in Older Adults With COVID-19 Pneumonia | en |
| Type | Research Article | en |
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