Selection of the Appropriate Control Group Is Essential in Evaluating the Cytokine Storm in COVID-19
Selection of the Appropriate Control Group Is Essential in Evaluating the Cytokine Storm in COVID-19
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DOI：
10.21873/invivo.12381
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发表时间：
2021-03-01
期刊：
影响因子：
2.3
通讯作者：
Kotanidou, Anastasia
中科院分区：
文献类型：
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作者：
Vassiliou, Alice G.;Dimopoulou, Ioanna;Kotanidou, Anastasia
背景/目的：最近，研究报告了在重症COVID-19患者中观察到的细胞因子风暴的相互矛盾的结果。根据所使用的对照组，与与细胞因子浓度升高相关的危重疾病相比，COVID-19中的细胞因子被发现更高，相似甚至更低。然而，这些研究中的大多数都没有考虑到危重疾病的严重程度。因此，我们决定比较重症COVID-19患者和普通重症监护室（ICU）重症患者的细胞因子水平，这些患者没有败血症或感染性休克，但疾病严重程度相同。患者和方法：在机械通气、COVID-19（N=36）和非COVID-19（N=30）患者（未接受地塞米松治疗且危重疾病严重程度相同）入住ICU时测量白细胞介素（IL）-6，IL-8，IL-10和肿瘤坏死因子-α（TNF-α）。非COVID-19患者没有败血症或感染性休克。结果如下：在我们的病例对照研究中，与重症非COVID-19患者相比，重症COVID-19患者的循环IL-6和IL-10较低，而TNF-α和IL-8水平较高。结论：很难推断COVID-19中观察到的细胞因子风暴是否与其他危急情况不同。重要的是要认识到，相关研究的结论可能取决于对照组的选择。
Background/Aim: Lately, studies have reported contradicting results on the cytokine storm seen in critically ill COVID-19 patients. Depending on the control group used, cytokines have been found to be higher, similar or even lower in COVID-19 compared to critical illnesses associated with elevated cytokine concentrations. However, most of these studies do not take into account critical illness severity. Hence, we decided to compare cytokine levels in critically-ill COVID-19 patients and critically-ill patients of a general intensive care unit (ICU), who did not have sepsis or septic shock, but had an equal disease severity. Patients and Methods: Interleukin (IL)-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-alpha) were measured on ICU admission in mechanically ventilated, COVID-19 (N=36) and non-COVID19 (N=30) patients, who had not received dexamethasone, and had equal critical illness severity. Non-COVID-19 patients did not have sepsis or septic shock. Results: In our case control study, circulating IL-6 and IL-10 were lower, while TNF-alpha and IL-8 levels were higher in critically-ill COVID-19 patients, compared to critically-ill non-COVID19 patients. Conclusion: It is difficult to infer whether the cytokine storm seen in COVID-19 differs from other critical conditions. It is important to recognize that the conclusions of related studies may depend on control group selection.