tetano
Editor, Senior Moderator
Nat Med
. 2020 Aug 24.
doi: 10.1038/s41591-020-1051-9. Online ahead of print.
An inflammatory cytokine signature predicts COVID-19 severity and survival
Diane Marie Del Valle[SUP] 1 2 3 [/SUP], Seunghee Kim-Schulze[SUP] 1 2 3 4 [/SUP], Hsin-Hui Huang[SUP] 5 6 7 [/SUP], Noam D Beckmann[SUP] 8 [/SUP], Sharon Nirenberg[SUP] 8 9 [/SUP], Bo Wang[SUP] 10 [/SUP], Yonit Lavin[SUP] 10 [/SUP], Talia H Swartz[SUP] 10 [/SUP], Deepu Madduri[SUP] 10 [/SUP], Aryeh Stock[SUP] 11 [/SUP], Thomas U Marron[SUP] 2 3 10 [/SUP], Hui Xie[SUP] 1 [/SUP], Manishkumar Patel[SUP] 1 [/SUP], Kevin Tuballes[SUP] 1 [/SUP], Oliver Van Oekelen[SUP] 8 [/SUP], Adeeb Rahman[SUP] 1 2 3 8 [/SUP], Patricia Kovatch[SUP] 8 9 [/SUP], Judith A Aberg[SUP] 10 [/SUP], Eric Schadt[SUP] 8 [/SUP], Sundar Jagannath[SUP] 10 [/SUP], Madhu Mazumdar[SUP] 5 6 7 [/SUP], Alexander W Charney[SUP] 8 [/SUP], Adolfo Firpo-Betancourt[SUP] 11 [/SUP], Damodara Rao Mendu[SUP] 11 [/SUP], Jeffrey Jhang[SUP] 11 [/SUP], David Reich[SUP] 12 [/SUP], Keith Sigel[SUP] 10 [/SUP], Carlos Cordon-Cardo[SUP] 11 [/SUP], Marc Feldmann[SUP] 13 [/SUP], Samir Parekh[SUP] 3 4 10 [/SUP], Miriam Merad[SUP] 1 2 3 4 10 [/SUP], Sacha Gnjatic[SUP] 14 15 16 17 18 19 [/SUP]
Affiliations
Abstract
Several studies have revealed that the hyper-inflammatory response induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major cause of disease severity and death. However, predictive biomarkers of pathogenic inflammation to help guide targetable immune pathways are critically lacking. We implemented a rapid multiplex cytokine assay to measure serum interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α and IL-1β in hospitalized patients with coronavirus disease 2019 (COVID-19) upon admission to the Mount Sinai Health System in New York. Patients (n = 1,484) were followed up to 41 d after admission (median, 8 d), and clinical information, laboratory test results and patient outcomes were collected. We found that high serum IL-6, IL-8 and TNF-α levels at the time of hospitalization were strong and independent predictors of patient survival (P < 0.0001, P = 0.0205 and P = 0.0140, respectively). Notably, when adjusting for disease severity, common laboratory inflammation markers, hypoxia and other vitals, demographics, and a range of comorbidities, IL-6 and TNF-α serum levels remained independent and significant predictors of disease severity and death. These findings were validated in a second cohort of patients (n = 231). We propose that serum IL-6 and TNF-α levels should be considered in the management and treatment of patients with COVID-19 to stratify prospective clinical trials, guide resource allocation and inform therapeutic options.
. 2020 Aug 24.
doi: 10.1038/s41591-020-1051-9. Online ahead of print.
An inflammatory cytokine signature predicts COVID-19 severity and survival
Diane Marie Del Valle[SUP] 1 2 3 [/SUP], Seunghee Kim-Schulze[SUP] 1 2 3 4 [/SUP], Hsin-Hui Huang[SUP] 5 6 7 [/SUP], Noam D Beckmann[SUP] 8 [/SUP], Sharon Nirenberg[SUP] 8 9 [/SUP], Bo Wang[SUP] 10 [/SUP], Yonit Lavin[SUP] 10 [/SUP], Talia H Swartz[SUP] 10 [/SUP], Deepu Madduri[SUP] 10 [/SUP], Aryeh Stock[SUP] 11 [/SUP], Thomas U Marron[SUP] 2 3 10 [/SUP], Hui Xie[SUP] 1 [/SUP], Manishkumar Patel[SUP] 1 [/SUP], Kevin Tuballes[SUP] 1 [/SUP], Oliver Van Oekelen[SUP] 8 [/SUP], Adeeb Rahman[SUP] 1 2 3 8 [/SUP], Patricia Kovatch[SUP] 8 9 [/SUP], Judith A Aberg[SUP] 10 [/SUP], Eric Schadt[SUP] 8 [/SUP], Sundar Jagannath[SUP] 10 [/SUP], Madhu Mazumdar[SUP] 5 6 7 [/SUP], Alexander W Charney[SUP] 8 [/SUP], Adolfo Firpo-Betancourt[SUP] 11 [/SUP], Damodara Rao Mendu[SUP] 11 [/SUP], Jeffrey Jhang[SUP] 11 [/SUP], David Reich[SUP] 12 [/SUP], Keith Sigel[SUP] 10 [/SUP], Carlos Cordon-Cardo[SUP] 11 [/SUP], Marc Feldmann[SUP] 13 [/SUP], Samir Parekh[SUP] 3 4 10 [/SUP], Miriam Merad[SUP] 1 2 3 4 10 [/SUP], Sacha Gnjatic[SUP] 14 15 16 17 18 19 [/SUP]
Affiliations
- PMID: 32839624
- DOI: 10.1038/s41591-020-1051-9
Abstract
Several studies have revealed that the hyper-inflammatory response induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major cause of disease severity and death. However, predictive biomarkers of pathogenic inflammation to help guide targetable immune pathways are critically lacking. We implemented a rapid multiplex cytokine assay to measure serum interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α and IL-1β in hospitalized patients with coronavirus disease 2019 (COVID-19) upon admission to the Mount Sinai Health System in New York. Patients (n = 1,484) were followed up to 41 d after admission (median, 8 d), and clinical information, laboratory test results and patient outcomes were collected. We found that high serum IL-6, IL-8 and TNF-α levels at the time of hospitalization were strong and independent predictors of patient survival (P < 0.0001, P = 0.0205 and P = 0.0140, respectively). Notably, when adjusting for disease severity, common laboratory inflammation markers, hypoxia and other vitals, demographics, and a range of comorbidities, IL-6 and TNF-α serum levels remained independent and significant predictors of disease severity and death. These findings were validated in a second cohort of patients (n = 231). We propose that serum IL-6 and TNF-α levels should be considered in the management and treatment of patients with COVID-19 to stratify prospective clinical trials, guide resource allocation and inform therapeutic options.