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Predictive Value of IL-6 and Lymphocyte Subsets for Death in Children With Influenza-Associated Encephalopathy A
Ruiyang Sun1, Xue Zhang1, Jiapu Hou1
1Emergency Department, Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
Insights
Interleukin-6 (IL-6) and specific lymphocyte subsets can predict mortality in children with influenza-associated encephalopathy (IAE). Combining these markers, including CD4+ T cells and NK cells, improves predictive accuracy for IAE deaths.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Influenza-associated encephalopathy (IAE) is a severe neurological complication of influenza.
- Identifying reliable biomarkers for predicting mortality in IAE is crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive value of interleukin-6 (IL-6) and lymphocyte subsets for mortality in pediatric patients with IAE.
- To compare the predictive efficacy of individual markers versus a combined panel.
Main Methods:
- Analysis of IL-6 levels and lymphocyte subsets (CD4+ T cells, CD8+ T cells, NK cells) in 76 children with IAE.
- Division of patients into death and survival groups.
- Receiver operating characteristic (ROC) curve analysis to assess predictive performance.
Main Results:
- Elevated IL-6 and NK cell percentages, with decreased CD4+ T cell and CD4+/CD8+ ratios, were observed in the non-survivors.
- Areas under the curve (AUCs) for IL-6, CD4+ T cells, CD4+/CD8+, and NK cells were 0.812, 0.810, 0.740, and 0.706, respectively.
- The combined AUC for these four markers reached 0.870, demonstrating superior predictive value compared to individual markers.
Conclusions:
- IL-6 concentration, CD4+ T cell percentage, NK cell percentage, and CD4+/CD8+ ratio are significant predictors of mortality in pediatric IAE.
- A combination of these biomarkers offers enhanced predictive accuracy for outcomes in children with IAE.
Abstract:
Objective: This study aims to investigate the predictive value of interleukin-6 (IL-6) and lymphocyte subsets for death in children with influenza-associated encephalopathy (IAE). Patients: This study included 76 children with IAE who were divided into a death group and a survival group. The differences in the levels of IL-6 and lymphocyte subsets between the two groups were analyzed, and the predictive value of these two parameters was compared by receiver operating characteristic (ROC) curve analysis. Results: The level of IL-6 and the percentage of natural killer (NK) cells in the death group were higher than those in the survival group (p < 0.05). The percentage of CD4+ T cells and CD4+/CD8+ levels in the death group were lower than those in the survival group. ROC curves were used for analysis, and the area under the curves (AUCs) of IL-6, the percentage of CD4+ T cells, the percentage of CD4+/CD8+, and the percentage of NK cells were 0.812, 0.810, 0.740, and 0.706, respectively. The AUC of the combination of these four metrics was 0.870. There was a little difference in the efficacy of the four clinical indicators, and the predictive efficacy of the combined test was higher than that of the single test. Conclusion: The IL-6 concentration, percentage of CD4+ T cells, percentage of NK cells, and CD4+/CD8+ have predictive value for death in children with IAE, and the combination of these four metrics has improved the predictive value.
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