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

Abstract

AbstractBackgroundMaintenance haemodialysis (HD) patients are at higher risk for severe coronavirus disease 2019 (COVID‐19). 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.MethodsThis 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.ResultsDuring 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.ConclusionCCL17 levels in HD patients with mild or moderate COVID‐19 predict risk of developing severe COVID‐19.