title: IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients.
abstract: Community-acquired pneumonia (CAP) is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II). The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and homocystein were collected at the time of admission (day 1) as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1) to 8 pg/mL (day 7) (P=0.016). The median levels of TNF-α were higher in patients: i) with acute kidney injury (AKI) (P=0.045), ii) requiring mechanical ventilation (P=0.040), iii) with short hospital stays (P=0.009), iv) admitted to the intensive care unit (ICU) (P=0.040), v) who died early (P=0.003), and vi) with worse CRB scores (P=0.013). In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI.
authors.affiliation: Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: M R
authors.initials: MR
authors.lastname: Bacci
authors.affiliation: Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: R C P
authors.initials: RC
authors.lastname: Leme
authors.affiliation: Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: N P C
authors.initials: NP
authors.lastname: Zing
authors.affiliation: Departamento de Cardiologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: N
authors.initials: N
authors.lastname: Murad
authors.affiliation: Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: F
authors.initials: F
authors.lastname: Adami
authors.affiliation: Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: P F
authors.initials: PF
authors.lastname: Hinnig
authors.affiliation: Departamento de Farmacologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: D
authors.initials: D
authors.lastname: Feder
authors.affiliation: Departamento de Cardiologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: A C P
authors.initials: AC
authors.lastname: Chagas
authors.affiliation: Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
authors.forename: F L A
authors.initials: FL
authors.lastname: Fonseca
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications / Q000401:mortality; D003404:Creatinine / Q000097:blood; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000401:mortality*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012737:Sex Factors; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D006710:Homocysteine; D002097:C-Reactive Protein; D003404:Creatinine