Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors
Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors
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分析COVID-19患者的血清细胞因子揭示IL-6和IL-10是疾病严重程度的预测因子
DOI：
10.1080/22221751.2020.1770129
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发表时间：
2020-01-01
影响因子：
13.2
通讯作者：
Xia, Yuchen
中科院分区：
文献类型：
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作者：
Han, Huan;Ma, Qingfeng;Xia, Yuchen
自2019年冠状病毒病(新冠肺炎)在武汉暴发以来，中国迅速在其他许多国家蔓延。虽然大多数患者被认为是轻微的，但涉及呼吸衰竭和多器官功能障碍综合征的危重患者并不少见，这可能会导致死亡。我们假设细胞因子风暴与严重后果相关。入选中国人民医院(武汉，中国)收治的新冠肺炎患者102例。所有患者根据症状分为中、重度和危重三组。另取45例健康志愿者作为对照。用特异性免疫分析法检测血清标本中炎症细胞因子和C反应蛋白(CRP)的变化。结果显示，新冠肺炎患者血清细胞因子(肿瘤坏死因子-α、干扰素-γ、IL-2、IL-4、IL-6、IL-10)和C反应蛋白水平均高于正常对照组。在新冠肺炎患者中，危重组(n=17)血清IL-6和IL-10水平显著高于中、重度组(n=43)。IL-10水平与C反应蛋白水平呈正相关(r=0.41，P<0.01)。单因素Logistic回归分析发现，IL-6和IL-10对病情严重程度有预测作用，受试者操作曲线分析进一步证实了这一结果(AUC分别为0.841和0.822)。我们的结果表明，较高水平的细胞因子风暴与更严重的疾病发展有关。其中，IL-6和IL-10可作为快速诊断病情恶化风险较高的患者的预测指标。鉴于SARS-CoV-2病毒诱导的高水平细胞因子，减少炎症相关的肺损伤的治疗至关重要。
Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, it has rapidly spread across many other countries. While the majority of patients were considered mild, critically ill patients involving respiratory failure and multiple organ dysfunction syndrome are not uncommon, which could result death. We hypothesized that cytokine storm is associated with severe outcome. We enrolled 102 COVID-19 patients who were admitted to Renmin Hospital (Wuhan, China). All patients were classified into moderate, severe and critical groups according to their symptoms. 45 control samples of healthy volunteers were also included. Inflammatory cytokines and C-Reactive Protein (CRP) profiles of serum samples were analyzed by specific immunoassays. Results showed that COVID-19 patients have higher serum level of cytokines (TNF-alpha, IFN-gamma, IL-2, IL-4, IL-6 and IL-10) and CRP than control individuals. Within COVID-19 patients, serum IL-6 and IL-10 levels are significantly higher in critical group (n = 17) than in moderate (n = 42) and severe (n = 43) group. The levels of IL-10 is positively correlated with CRP amount (r = 0.41,P < 0.01). Using univariate logistic regression analysis, IL-6 and IL-10 are found to be predictive of disease severity and receiver operating curve analysis could further confirm this result (AUC = 0.841, 0.822 respectively). Our result indicated higher levels of cytokine storm is associated with more severe disease development. Among them, IL-6 and IL-10 can be used as predictors for fast diagnosis of patients with higher risk of disease deterioration. Given the high levels of cytokines induced by SARS-CoV-2, treatment to reduce inflammation-related lung damage is critical.