Soluble Interleukin-2 Receptor Level in Hypertensive Patients with COVID-19-associated Pneumonia

Keywords: COVID-19, Hypertension, sIL-2R,, Prediction, Pneumonia


Introduction. Soluble interleukin-2 receptor (sIL-2R) is considered to be an important biomarker that reflects the condition of patients with COVID-19. The establishment of its predictive ability in hypertensive patients with COVID-19-associated pneumonia is perspective.

Aim. This study aimed to evaluate of serum sIL-2R level and to establish its predictive ability for severe/critical clinical condition and mortality in patients with COVID-19-associated pneumonia and arterial hypertension.

Materials and methods. 135 unvaccinated adult patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. 106 (78.5%) patients were hypertensive.

 Results. There was higher median serum sIL-2R level at hospital admission in hypertensive patients (5.87 [4.51–8.16] ng/mL) than in non-hypertensive patients (4.99 [3.56–6.14] ng/mL) (p=0.037). There was no statistically significant difference in sIL-2R levels at admission in patients with moderate, severe and critical clinical conditions among hypertensive patients (p=0.171 according to the Kruskal-Wallis test). But among non-hypertensive patients, serum sIL-2R was higher in patients with severe condition (5.73 [4.90–8.90] ng/mL) than in patients with moderate condition (3.87 [2.71–5.37] ng/mL) (p=0.041 according to the Kruskal-Wallis test, post-hoc Dunn’s test: p=0.012). There was no statistically significant difference in the median serum sIL-2R level between non-survivors (7.80 [5.96–9.94] ng/mL) and survivors (5.62 [4.29–7.71] ng/mL) (p=0.066). In hypertensive patients, serum sIL-2R level failed to predict in-hospital mortality (AUC=0.664, p=0.075), development of severe/critical clinical conditions (AUC=0.583, p=0.138), and need for supplemental oxygen (AUC=0.589, p=0.121).

Conclusions. Hypertensive patients have higher serum sIL-2R levels at hospital admission than non-hypertensive patients. There is no statistically significant association between sIL-2R level at hospital admission and disease severity or in-hospital mortality in hypertensive patients. sIL-2R level at hospital admission failed to predict in-hospital mortality, development of severe/critical conditions, and need for supplemental oxygen in hypertensive patients. sIL-2R level is suggested to have the poor predictive ability in hypertensive patients.

Keywords: COVID-19, hypertension, sIL-2R, prediction, pneumonia.


World Health Organization. WHO COVID-19 Dashboard [Internet]. World Health Organization. 2022. Available from: (Available 12 August 2022).

Jun S, Jie L, Jiamin L, Ling Y, Jinjun J, Yuanlin S. Therapy for severe and critical corona virus disease 2019 and healthcare personnel protection. Shanghai Med J. Published online: 23 March 2020. Available at (Available 12 August 2022).

Alimohamadi Y, Tola HH, Abbasi-Ghahramanloo A, Janani M, Sepandi M. Case fatality rate of COVID-19: a systematic review and meta-analysis. J Prev Med Hyg. 2021;62(2):E311-E320. doi: 10.15167/2421-4248/jpmh2021.62.2.1627.

Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-481. Available from:

Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. J Am Med Assoc. (2020) 324:782-93. Available from:

Pranata R, Lim MA, Huang I, Raharjo SB, Lukito AA. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression. J Renin Angiotensin Aldosterone Syst. 2020;21(2):1470320320926899. Available from:

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. Available from:

Tam AR, Zhang RR, Lung KC, Liu R, Leung KY, Liu D, et al. Early treatment of high-risk hospitalized COVID-19 patients with a combination of interferon beta-1b and remdesivir: a phase 2 open-label randomized controlled trial [published online ahead of print, 2022 Jun 28]. Clin Infect Dis. 2022;ciac523. Available from:

Gupta A, Gonzalez-Rojas Y, Juarez E, et al. Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab. N Engl J Med. 2021;385(21):1941-1950. Available from:

Alexander PE, Armstrong R, Fareed G, et al. Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents. Med Hypotheses. 2021;153:110622. Available from:

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. Available from:

Velavan TP, Meyer CG. Mild versus severe COVID-19: Laboratory markers. Int J Infect Dis. 2020;95:304-307. Available from:

Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-1028. Available from:

Dhar SK, K V, Damodar S, Gujar S, Das M. IL-6 and IL-10 as predictors of disease severity in COVID-19 patients: results from meta-analysis and regression. Heliyon. 2021 Feb;7(2):e06155. Available from:

Gatselis NK, Lygoura V, Lyberopoulou A, Giannoulis G, Samakidou A, Vaiou A, et al. Soluble IL-2R Levels at Baseline Predict the Development of Severe Respiratory Failure and Mortality in COVID-19 Patients. Viruses. 2022;14(4):787. Available from:

Eurelings LEM, Miedema JR, Dalm VASH, van Daele PLA, van Hagen PM, van Laar JAM, Dik WA. Sensitivity and specificity of serum soluble interleukin-2 receptor for diagnosing sarcoidosis in a population of patients suspected of sarcoidosis. PLoS One. 2019 Oct 17;14(10):e0223897. Available from:

Vanmaris RMM, Rijkers GT. Biological role of the soluble interleukin-2 receptor in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(2):122-129. doi: 10.36141/svdld.v34i2.5369.

Jang HJ, Leem AY, Chung KS, Ahn JY, Jung JY, Kang YA, et al. Soluble IL-2R Levels Predict in-Hospital Mortality in COVID-19 Patients with Respiratory Failure. J Clin Med. 2021;10(18):4242. Available from:

Kaya H, Kaji M, Usuda D. Soluble interleukin-2 receptor levels on admission associated with mortality in coronavirus disease 2019. Int J Infect Dis. 2021;105:522-524. Available from:

Garg S, Kim L, Whitaker M, O'Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019-COVID-NET, 14 states, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:458-64. Available from:

Durda P, Sabourin J, Lange EM, Nalls MA, Mychaleckyj JC, Jenny NS, et al. Plasma Levels of Soluble Interleukin-2 Receptor α: Associations With Clinical Cardiovascular Events and Genome-Wide Association Scan. Arterioscler Thromb Vasc Biol. 2015;35(10):2246-53. Available from:

Ministerstvo Okhorony Zdorovia Ukrainy. Derzhavnyi Ekspertnyi Tsentr [Internet]. Protokol «Nadannia medychnoi dopomohy dlia likuvannia koronavirusnoi khvoroby (COVID-19)» [cited 2022 Jul 1]. Available from:

Azmy V, Kaman K, Tang D, Zhao H, Dela Cruz C, Topal JE, et al. Cytokine Profiles Before and After Immune Modulation in Hospitalized Patients with COVID-19. Journal of Clinical Immunology. 2021;41(4):738-47. Available from:

Zhang, Y., Wang, X., Li, X. et al. Potential contribution of increased soluble IL-2R to lymphopenia in COVID-19 patients. Cell Mol Immunol 17, 878-880 (2020). Available from:

Original Research