IFN-γ is an independent risk factor associated with mortality in patients with moderate and severe COVID-19 infection.
IFN-γ is an independent risk factor associated with mortality in patients with moderate and severe COVID-19 infection.
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DOI：
10.1016/j.virusres.2020.198171
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发表时间：
2020-11
期刊：
影响因子：
5
通讯作者：
Tuon FF
中科院分区：
文献类型：
--
作者：
Gadotti AC;de Castro Deus M;Telles JP;Wind R;Goes M;Garcia Charello Ossoski R;de Padua AM;de Noronha L;Moreno-Amaral A;Baena CP;Tuon FF
炎症先天免疫可以被描述为预后因素。 Th1 和 Th2 反应之间的平衡可能与中度至重度 COVID-19 感染患者的死亡率相关。 IFN-γ是与SARS-Cov2患者死亡相关的独立危险因素。已在感染了 COVID-19 的患者中评估了先天性和适应性免疫反应。这种疾病的严重程度被认为与其他细菌性和病毒性肺炎未报道的一些情况有关。我们提出了一项针对中度至重度 COVID-19 感染患者的研究，以评估白细胞介素模式及其作为预后因素的作用。 2020 年 6 月至 7 月中度和重度 COVID-19 感染病例的前瞻性队列。定期采集患者的血样以评估 IFN-γ、TNF-α、IL-4、IL-6 和 IL-10。记录临床、实验室、放射学数据和结果。结果变量是院内死亡、生存、机械通气和入住重症监护室。数据以中位数和四分位数范围 [IQR] 表示。我们根据进化评估了 Th1 和 Th2 反应，区分可能的预测标记。死亡患者的 IFN-γ 中位数为 323 pg/mL [IQR 166−570]，存活组的 IFN-γ 中值为 208 pg/mL [IQR 155−392] (p = 0.017)。 IFN-γ 在疾病早期阶段也较高（394 pg/mL [IQR 229–575] 对比 162 pg/mL [IQR 117–259]，p < 0.001）。 IL-4 在晚期有所增加（182 pg/mL [IQR 162–199] 对比 131 pg/mL [IQR 124–152]，p < 0.001），但与死亡率无关。此外，死亡也与男性相关（相对风险 = 1.5 [95% 置信区间 = 1.1−2.0]）。我们的研究结果表明，COVID-19感染中Th1或Th2之间宿主免疫反应的激活可能与出院或死亡之间的最终结果有关。这意味着尝试通过临床治疗的联合疗法来控制细胞因子，例如IFN-γ。
Inflammatory innate immunity can be described as prognostic factors. The balancing between Th1 and Th2 response can be associated with mortality in patients with moderate to severe COVID-19 infection. IFN-γ was an independent risk factor associated with mortality in patients with SARS-Cov2. Innate and adaptive immune responses have been evaluated in infected patients with COVID-19. The severity of the disease has been supposed to be associated with some profile not reported with other bacterial and viral pneumonia. We proposed a study in patients with moderate to severe COVID-19 infection to evaluate the interleukin patterns and its role as prognosis factors. A prospective cohort with moderate and severe cases of COVID-19 infection from June to July 2020. Blood samples from patients were collected regularly to evaluate IFN-γ, TNF-α, IL-4, IL-6, and IL-10. Clinical, laboratory, radiological data, and outcomes were recorded. The outcome variable was in-hospital death, survival, mechanical ventilation, and admission at the intensive care unit. Data are presented in median and interquartile range [IQR]. We evaluated the Th1 and Th2 responses according to evolution, distinguishing possible predictive markers. The IFN-γ median of 323 pg/mL [IQR 166−570] was found in patients who died and 208 pg/mL [IQR 155−392] in the survival group (p = 0.017). IFN-γ was also higher in the early stages of the disease (394 pg/mL [IQR 229–575] against 162 pg/mL [IQR 117–259], p < 0.001). IL-4 that was increased in late-stage (182 pg/mL [IQR 162–199] against 131 pg/mL [IQR 124–152], p < 0.001) but not associated with mortality. Also, death was also related to male gender (relative risk = 1.5 [95 % confidence interval = 1.1−2.0]). Our results suggest that the activation of the host immune response between Th1 or Th2 in COVID-19 infection may be related to the final result between discharge or death. This implies an attempt to control cytokines, such as IFN-γ, with combined therapies for clinical treatment.
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