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Pediatr Pulmonol . Cytokine profile in Egyptian children and adolescents with COVID-19 pneumonia: a multicenter study

tetano

Editor, Senior Moderator
Pediatr Pulmonol


. 2021 Sep 18.
doi: 10.1002/ppul.25679. Online ahead of print.
Cytokine profile in Egyptian children and adolescents with COVID-19 pneumonia: a multicenter study


Hala K Shafiek[SUP] 1 [/SUP], Hanan M Abd El Lateef[SUP] 2 [/SUP], Naglaa F Boraey[SUP] 3 [/SUP], Mohamed Nashat[SUP] 4 [/SUP], Ghada A B Abd-Elrehim[SUP] 3 [/SUP], Heba Abouzeid[SUP] 5 [/SUP], Sahbaa F M Hafez[SUP] 5 [/SUP], Hassan Shehata[SUP] 5 [/SUP], Ahmed A Elhewala[SUP] 5 [/SUP], Alsayed Abdel-Aziz[SUP] 5 [/SUP], Nancy M S Zeidan[SUP] 6 [/SUP], Mohammed M Soliman[SUP] 6 [/SUP], Mohammad M Sallam[SUP] 7 [/SUP], Abdalla M Nawara[SUP] 7 [/SUP], Elsayed A Elgohary[SUP] 7 [/SUP], Abdallah I Badr[SUP] 8 [/SUP], Dalia M Selim[SUP] 2 [/SUP], Suzan A Razek[SUP] 2 [/SUP], Batoul M Abdel Raouf[SUP] 2 [/SUP], Hani A Elmikaty[SUP] 9 [/SUP], Lamya M Ibrahim[SUP] 10 [/SUP], Gehan H Shahin[SUP] 11 [/SUP], Rehab M Nabil[SUP] 12 [/SUP], Mohamed A M Ibrahim[SUP] 13 [/SUP], Hanan F Salem[SUP] 14 [/SUP], Ahmed A M Moustafa[SUP] 14 [/SUP], Naglaa A Elshehawy[SUP] 15 [/SUP], Marwa M Abdel-Aziz[SUP] 15 [/SUP], Heba H Eltrawy[SUP] 16 [/SUP], Sherif F Osman[SUP] 17 [/SUP], Rania A Fouad[SUP] 18 19 [/SUP], Mona R Afify[SUP] 20 [/SUP], Mohamed Y Mohamed[SUP] 21 [/SUP], Yousif M Yousif[SUP] 5 [/SUP], Aly A Yousef[SUP] 22 [/SUP], Mohamed A Arafa[SUP] 5 [/SUP]



Affiliations

Abstract

Background: To date, the cytokine profile in children and adolescent with novel coronavirus disease 2019 (COVID-19) has not been reported.
Objectives: we investigated serum levels of a panel of key cytokines in children and adolescent with COVID-19 pneumonia with a primary focus on "cytokine storm" cytokines such as IL-1β, IL-6, IL-17, IL-2, IL-4, IL-10, interferon (IFN-γ), tumor necrosis factor (TNF)-α and two chemokines interferon inducible protein-10 (IP-10) and IL-8]. We also studied whether these cytokines could be potential markers for illness severity in COVID-19 pneumonia.
Methods: Ninety-two symptomatic patients aged less than 18 years with confirmed COVID-19 pneumonia and 100 well-matched healthy controls were included in this multi-center study. For all patients, the presence of SARS-CoV-2 in respiratory fluid specimens was detected by real-time reverse-transcriptase-PCR (RT-PCR). We measured serum concentrations of studied cytokines by using flow cytometry.
Results: Patients with COVID-19 had significantly higher median IL-1β, IL-6, IL-8, IL-10, IL-17, TNF-α and IP-10 serum levels than did control children (all P < 0.01). Patients with severe COVID-19 pneumonia had significantly higher median IL-1β, IL-6 and IP-10 serum levels as compared with those with moderate COVID-19 pneumonia; all P < 0.01. ROC analysis revealed that three of the studied markers (IL-6, IL-1β and IP-10) could predict severe COVID-19 pneumonia cases with the largest AUC for IL-6 of 0.893 (95% CI: 0.84-0.98; P < 0.01).
Conclusion: Our study shows that pediatric patients with COVID-19 pneumonia have markedly elevated serum IL-1β, IL-6, IL-8, IL-10, IL-17, TNF-α and IP-10 levels at the initial phase of the illness indicating a cytokine storm following SARS-CoV-2 infection. Moreover, serum IL-6, IL-1β, and IP-10 concentrations were independent predictors for severe COVID-19 pneumonia. This article is protected by copyright. All rights reserved.

Keywords: adolescents; children; coronavirus disease 2019 (COVID-19); cytokine profile; pneumonia.
 
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