tetano
Editor, Senior Moderator
BMJ Open
. 2020 Nov 30;10(11):e041471.
doi: 10.1136/bmjopen-2020-041471.
Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study
Qing Quan Liu[SUP] #[/SUP][SUP] 1 [/SUP], Anying Cheng[SUP] #[/SUP][SUP] 1 [/SUP], Yiru Wang[SUP] 1 [/SUP], Haifang Li[SUP] 2 [/SUP], Liu Hu[SUP] 3 [/SUP], Xuecheng Zhao[SUP] 3 [/SUP], Tao Wang[SUP] 4 [/SUP], Fan He[SUP] 5 [/SUP]
Affiliations
Abstract
Objective: To delineate the characteristics and clinical significance of plasma inflammatory cytokines altered in COVID-19.
Design: Retrospective, single-centre cohort study.
Setting: Tongji Hospital in Wuhan, China.
Participants: Among a cohort of 308 patients with a diagnosis of COVID-19, 138 patients died while 170 patients recovered and were discharged from the hospital. The data were collected until 27 February 2020.
Primary and secondary outcome measures: Clinical characteristics and laboratory findings were obtained from electronic medical records using data collection forms.
Results: The percentage of patients with elevated interleukin 2 receptor (IL-2R), IL-6, IL-8, IL-10 and tumour necrosis factor (TNF) increased with severity of disease (p<0.0001 for all). IL-2R (p<0.0001), IL-6 (p<0.0001), IL-8 (p=0.0001), IL-10 (p<0.0001) and TNF (p<0.0001) were also twofold to 20-fold higher in patients who died compared with those who recovered. Also, IL-6 and IL-10 increased in both the progressive patient groups: moderate (p=0.0026) and severe (p<0.0001). In multivariate analysis, higher levels of IL-2R (OR 1.001, 95% CI 1.000 to 1.002, p=0.031) and IL-6 (OR 1.013, 95% CI 1.003 to 1.024, p=0.015) on admission were associated with increasing odds of in-hospital death, independent of other covariates, including severity of disease and lymphocyte count.
Conclusion: Increased proinflammatory and anti-inflammatory cytokines, including IL-2R, IL-6, IL-8, TNF and IL-10, showed an obvious association with both COVID-19 severity and in-hospital mortality. Thus, our study indicates that cytokines are valuable in predicting the severity of COVID-19 and helps in distinguishing critically ill patients from the less affected ones.
Keywords: COVID-19; immunology; infection control; respiratory infections.
. 2020 Nov 30;10(11):e041471.
doi: 10.1136/bmjopen-2020-041471.
Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study
Qing Quan Liu[SUP] #[/SUP][SUP] 1 [/SUP], Anying Cheng[SUP] #[/SUP][SUP] 1 [/SUP], Yiru Wang[SUP] 1 [/SUP], Haifang Li[SUP] 2 [/SUP], Liu Hu[SUP] 3 [/SUP], Xuecheng Zhao[SUP] 3 [/SUP], Tao Wang[SUP] 4 [/SUP], Fan He[SUP] 5 [/SUP]
Affiliations
- PMID: 33257492
- DOI: 10.1136/bmjopen-2020-041471
Abstract
Objective: To delineate the characteristics and clinical significance of plasma inflammatory cytokines altered in COVID-19.
Design: Retrospective, single-centre cohort study.
Setting: Tongji Hospital in Wuhan, China.
Participants: Among a cohort of 308 patients with a diagnosis of COVID-19, 138 patients died while 170 patients recovered and were discharged from the hospital. The data were collected until 27 February 2020.
Primary and secondary outcome measures: Clinical characteristics and laboratory findings were obtained from electronic medical records using data collection forms.
Results: The percentage of patients with elevated interleukin 2 receptor (IL-2R), IL-6, IL-8, IL-10 and tumour necrosis factor (TNF) increased with severity of disease (p<0.0001 for all). IL-2R (p<0.0001), IL-6 (p<0.0001), IL-8 (p=0.0001), IL-10 (p<0.0001) and TNF (p<0.0001) were also twofold to 20-fold higher in patients who died compared with those who recovered. Also, IL-6 and IL-10 increased in both the progressive patient groups: moderate (p=0.0026) and severe (p<0.0001). In multivariate analysis, higher levels of IL-2R (OR 1.001, 95% CI 1.000 to 1.002, p=0.031) and IL-6 (OR 1.013, 95% CI 1.003 to 1.024, p=0.015) on admission were associated with increasing odds of in-hospital death, independent of other covariates, including severity of disease and lymphocyte count.
Conclusion: Increased proinflammatory and anti-inflammatory cytokines, including IL-2R, IL-6, IL-8, TNF and IL-10, showed an obvious association with both COVID-19 severity and in-hospital mortality. Thus, our study indicates that cytokines are valuable in predicting the severity of COVID-19 and helps in distinguishing critically ill patients from the less affected ones.
Keywords: COVID-19; immunology; infection control; respiratory infections.