Background/Objectives: The function of adipokines, which play an important role in the etiopathogenesis of critical illness, has not been fully elucidated. We aim to investigate the sequential changes in serum adipokines and their association with clinical outcomes and nutritional parameters in ICU patients with SARS-CoV-2. Methods: This observational study was conducted prospectively in a Medical ICU. Blood samples were collected on admission and on the 7th day for analysis of adiponectin, GLP-1, resistin, visfatin, acyl ghrelin (AG), IGF-1, and leptin levels using ELISA kits. Results: This study included 30 critically ill patients and 10 healthy controls. Baseline and day 7 serum adiponectin, GLP-1, resistin, visfatin, baseline AG and day 7 IGF-1 levels are significantly lower in critically ill patients compared to the control group (p<0.05). A negative correlation was observed between time to initiate nutrition and serum adipokine levels (p<0.05). Patients with high mNUTRIC scores had elevated serum adiponectin and IGF-1 levels on day 7 (p<0.05). Positive correlations were found between MV duration and day 7 AG levels (p<0.05). Conclusions: This pilot study provides insights into serum adipokine dynamics in critically ill COVID-19 patients. Lower adiponectin, GLP-1, resistin, visfatin, AG, and IGF-1 levels suggest dysregulation in these pathways.

Background: Infections are frequent in critically ill patients with earthquake‐associated crush injury (CI) and contribute to poor outcomes, yet the immune pathways underlying posttrauma susceptibility remain poorly defined. We investigated longitudinal changes in damage‐associated molecular pattern (DAMP)/PAMP sensing and downstream inflammatory programs in CI patients requiring intensive care. Methods: Nineteen CI patients admitted to the ICU after the February 6, 2023 Kahramanmaraş earthquake and 18 age‐ and sex‐matched healthy controls were enrolled. Peripheral blood was collected on hospital days 7 and 21. DAMP/PAMP receptor expression was assessed by flow cytometry and RT‐qPCR, and pathway activation was evaluated by phospho‐flow (pSTING, pIRF3, pNF‐κB, and p‐cJun) in gated lymphocytes and monocytes. Plasma cytokines/alarmins and select DAMPs were quantified by multiplex enzyme‐linked immunosorbent assay (ELISA)/assays. Results: CI patients demonstrated broad remodeling of nucleic acid‐sensing programs, including reduced expression of TLR7, STING, and IRF7, with a discordant signaling pattern characterized by increased IRF3 phosphorylation, transiently reduced pSTING, and sustained reduction of p‐cJun, while NF‐κB activation remained comparatively stable. In plasma, IL‐33 and IFN‐α2 were reduced on Day 7, and type 3 immunity‐associated cytokines IL‐23 and IL‐17A were significantly decreased by Day 21, consistent with impaired antimicrobial barrier‐supporting responses. Circulating DAMPs were dynamically altered, with increased S100A9 and HMGB1 and decreased ATP following injury. Conclusions: Earthquake‐associated CI is associated with dynamic DAMP release and dysregulated innate sensing accompanied by suppression of antiviral and type 3 immune cytokine programs. These immune alterations may contribute to heightened vulnerability to secondary infections in critically ill CI patients.

Background/Objectives: Patients with hematologic malignancies represent a high-risk population requiring intensive care due to infections, organ failure, and treatment-related complications. Despite advances in oncologic therapies and intensive care management, mortality remains high. This study aimed to evaluate prognostic factors and clinical outcomes in critically ill patients with hematologic malignancies admitted to the intensive care unit (ICU). Methods: Adult patients (≥18 years) with hematologic malignancies who were admitted to a medical ICU and stayed for at least 48 h were retrospectively included. Demographic characteristics, laboratory parameters, and APACHE II, SOFA, EASIX, and HALP scores, as well as mortality and organ support requirements, were evaluated. Results: A total of 108 patients were included. The median age was 61 years (IQR: 49–70), and 61% were male. The 28-day mortality was 64.8%. Overall, 83.3% of patients required invasive mechanical ventilation for at least 24 h. The median ICU length of stay was 5 days (IQR: 3–10). Median APACHE II and SOFA scores were 22 (IQR: 16–28) and 9 (IQR: 6–11), respectively. In multivariate analysis, SOFA score (OR: 1.218, 95% CI: 1.022–1.451) and the highest BUN level during ICU stay (OR: 1.034, 95% CI: 1.008–1.060) were independently associated with intubation. Admission creatinine level was the only independent predictor of renal replacement therapy (OR: 1.948, 95% CI: 1.081–3.510). APACHE II score was the only variable independently associated with 28-day mortality (OR: 1.064, 95% CI: 1.002–1.129). Conclusions: APACHE II showed a modest but statistically significant association with 28-day mortality in this cohort. Intubation and RRT requirements were mainly associated with organ dysfunction severity and renal impairment. Larger multicenter studies are needed to validate these findings and to better define risk stratification in critically ill hematologic patients.

Adipokines regulate metabolic and inflammatory pathways and may be altered during critical illness. We explored sequential serum adipokine concentrations and their associations with nutritional and clinical variables in critically ill COVID-19 patients. This prospective observational, exploratory study included 30 critically ill COVID-19 patients and 10 age- and sex-matched healthy controls. Serum adiponectin, resistin, GLP-1, visfatin, IGF-1, leptin, and acylated ghrelin were measured at intensive care unit admission and on day 7. Biomarker-clinical correlations were analyzed using Spearman correlation, and the Benjamini–Hochberg false discovery rate procedure was applied to account for multiple biomarker comparisons. After false discovery rate correction, longer time to nutrition initiation remained inversely associated with day-7 adiponectin (ρ = −0.464, q = 0.027), GLP-1 (ρ = −0.568, q = 0.015), IGF-1 (ρ = −0.488, q = 0.022), leptin (ρ = −0.539, q = 0.015), and acylated ghrelin (ρ = −0.503, q = 0.021). Several adipokines showed exploratory associations with nutrition-initiation time in this small cohort of critically ill COVID-19 patients. These observational findings do not establish that earlier nutritional support causes changes in adipokine concentrations and require validation in larger, adequately controlled studies.