Prognostic Value of CD14 Expression in Peripheral Blood Mononuclear Cell Membrane in Patients with Severe COPD Complicated with Pulmonary Infection.

Abstract

Severe chronic obstructive pulmonary disease (COPD) patients with pulmonary infections face higher morbidity and mortality. To investigate mononuclear cell membrane CD14 as a prognostic marker for their outcome. A total of 311 participants were included: 122 in the coinfection group, 127 in the severe COPD group, and 62 in the control group. The patients in the coinfection group were categorized into survival (n=106) and death (n=16) groups based on hospitalization prognosis. The CD14%, CD14MFI, and CD14IND values were compared between the groups. Death risk factors were assessed by COPD grading, FEV1% pred, FEV1/FVC, CD14%, CD14MFI, and CD14IND. Correlations between CD14 parameters and mortality, COPD grade, FEV1%pred, and FEV1/FVC were analyzed. The critical value for CD14IND to predict patient death was determined and survival rates were compared between the high and the low-risk groups. CD14% values were significantly lower in the COPD and co-infection groups than in the control groups (p<0.05). The survival group showed a steady increase in mCD14 expression, while the death group showed fluctuating low levels. Low value of CD14% was identified as a risk factor for death and correlated with mortality and COPD severity (p<0.001). CD14IND≤74.36 predicted death with 91.22% sensitivity and 95.51% specificity. The high-risk group had a significantly lower 30-day survival rate (68.42%) compared with the low-risk group (95.24%) (log-rank χ2=10.067, p=0.002). The CD14 parameters of mononuclear cell membranes prove to be promising markers for predicting prognosis and death in severe COPD patients with lung infection.