By: Yuyu Lu, Ling Wu, Lingling Nie
Keywords: C-reactive protein; Interleukin 6; Lymphocyte-to-high-density lipoprotein ratio; Procalcitonin; Prognosis; Septic shock; T-lymphocyte subsets; Vitamin C
DOI : 10.36721/PJPS.2026.39.1.REG.14162.1
Abstract: Background: Septic shock remains a critical condition with high mortality, necessitating reliable prognostic biomarkers and effective adjunct therapies. Objectives: This study explored prognostic biomarkers and the effect of vitamin C in septic shock. Methods: This study analyzed 110 patients (January 2023-March 2024), stratified by 28-day outcome into survival (n=90) and death (n=20) groups. Compared to survivors, the death group exhibited significantly lower lymphocyte-to-high-density lipoprotein ratio (LHR), CD3+, CD3+CD4+, CD4+/CD8+ and higher interleukin 6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), CD3+CD8+. Results: The receiver operating characteristic analysis showed the combination of LHR, IL-6, CRP, PCT and CD4+/CD8+ predicted death best [area under the receiver operating characteristic curve (AUC) =0.960], outperforming single markers. Patients were randomized to control (hydrocortisone) or observation (hydrocortisone with vitamin C) group. Post-treatment, both groups showed improved mean arterial pressure (MAP), central venous pressure (CVP) (increased), heart rate (HR) (decreased) and reduced PCT, tumor necrosis factor-? (TNF-?), IL-6 and Sequential Organ Failure Assessment (SOFA) score; however, improvements were significantly greater in the vitamin C group. Conclusion: The combination of LHR, IL-6, CRP, PCT and CD4+/CD8+ has prognostic value. Vitamin C adjunct therapy significantly enhances hemodynamic improvement, reduces inflammation, lowers SOFA scores and improves prognosis in septic shock patients.
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