{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:03:41Z","timestamp":1783613021272,"version":"3.55.0"},"reference-count":38,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is increasing evidence that inflammation is an important determinant in COVID-19 pathogenesis. Several studies describe cytokines and microRNAs as important regulators of immune and inflammatory responses in other diseases, regarding them as valuable biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Identify a potential relationship between cytokines (interleukin [IL]-6, IL-8) and microRNAs (miR-146a-5p, miR-155-5p) and clinical characteristics of COVID-19 patients, focusing on disease severity and mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serum expression levels of miR-146a, miR-155, IL-6, IL-8, C-reactive protein, ferritin, and neutrophil-to-lymphocyte ratio, of 25 mild, 73 moderate, and 39 severe COVID-19 patients from Quito-Ecuador, were determined to correlate outcomes with clinical parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In all groups, overweight and obesity were the most prevalent comorbidities (75.91%). Serum levels of IL-6 were significantly elevated in patients with moderate and severe COVID-19 (analysis of variance [ANOVA]\n                      <jats:italic>p<\/jats:italic>\n                      \u2264 0.000). miR-146a was significantly decreased in moderate and severe COVID-19 patients when compared with mild cases (ANOVA\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). ROC curve analysis showed that selected cut-off values for miR-146a &gt; 3.999 \u0394Ct for mild vs moderate condition (sensitivity 83.56%, specificity 48%) and miR-146a &gt; 3.999 \u0394Ct for mild vs severe condition (sensitivity 84.62%, specificity 40%), and IL-6 \u2265 72.25\u2009pg\/mL (sensitivity 78.95%, specificity 60.61%) when combined with clinical pretest probability, can be used to predict aggravation and death in COVID-19 patients. Odds ratios (ORs) of miR-146a (OR = 4.322) and IL-6 (OR = 3.198) indicate an increased risk of worsening and death, respectively, when cut-off points were taken into consideration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study shows that elevated inflammatory IL-6 and decreased serum levels of anti-inflammatory miR-146a-5p can be discriminatory markers of COVID-19 severity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/bmc-2025-0052","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T14:16:17Z","timestamp":1761142577000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical spectrum of COVID-19 patients and decreased serum level of miR-146a as a sign of inflammation"],"prefix":"10.1515","volume":"16","author":[{"given":"Lucy","family":"Balde\u00f3n Rojas","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Central University of Ecuador , Quito , Ecuador"},{"name":"Research Institute of Biomedicine, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"P\u00e9rez-Galarza","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Alulema","sequence":"additional","affiliation":[{"name":"Research Institute of Biomedicine, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosselin","family":"Vicu\u00f1a-Almeida","sequence":"additional","affiliation":[{"name":"Research Institute of Biomedicine, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Salinas-Pinta","sequence":"additional","affiliation":[{"name":"Research Institute of Biomedicine, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ca\u00f1adas Herrera","sequence":"additional","affiliation":[{"name":"Research Institute of Biomedicine, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Luis","family":"V\u00e9lez-Paez","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Central University of Ecuador , Quito , Ecuador"},{"name":"Intensive Care Unit, Clinical Research Center, Pablo Arturo Suarez Hospital , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda Ruiz","family":"Borja","sequence":"additional","affiliation":[{"name":"Research Institute of Biomedicine, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"Pr\u00f3cel Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Metropolitan Hospital , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Heredia","sequence":"additional","affiliation":[{"name":"Emergency Unit, Calderon General Teaching Hospital , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Barahona","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Calderon General Teaching Hospital , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Semp\u00e9rtegui Ontaneda","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Central University of Ecuador , Quito , Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"2025120518004537439_j_bmc-2025-0052_ref_001","doi-asserted-by":"crossref","unstructured":"Choudhri Y, Maslove DM, Rauh MJ. 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