An inflammatory cytokine signature predicts COVID-19 severity and survival.
An inflammatory cytokine signature predicts COVID-19 severity and survival.
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DOI：
10.1038/s41591-020-1051-9
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发表时间：
2020-10
期刊：
影响因子：
82.9
通讯作者：
Gnjatic S
中科院分区：
文献类型：
--
作者：
Del Valle DM;Kim-Schulze S;Huang HH;Beckmann ND;Nirenberg S;Wang B;Lavin Y;Swartz TH;Madduri D;Stock A;Marron TU;Xie H;Patel M;Tuballes K;Van Oekelen O;Rahman A;Kovatch P;Aberg JA;Schadt E;Jagannath S;Mazumdar M;Charney AW;Firpo-Betancourt A;Mendu DR;Jhang J;Reich D;Sigel K;Cordon-Cardo C;Feldmann M;Parekh S;Merad M;Gnjatic S
一些研究表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）诱导的高度炎症反应是疾病严重程度和死亡的主要原因。然而，严重缺乏有助于指导靶向免疫途径的致病性炎症的预测性生物标志物。我们实施了一种快速多重细胞因子测定法，以测量纽约西奈山卫生系统（Mount Sinai Health System）收治的2019冠状病毒病（COVID-19）住院患者的血清白细胞介素（IL）-6，IL-8，肿瘤坏死因子（TNF）-α和IL-1β。患者（n = 1，484）随访至入院后41 d（中位数，8 d），收集临床信息、实验室检查结果和患者结局。我们发现，住院时血清IL-6、IL-8和TNF-α水平升高是患者生存率的独立预测因子（分别为P < 0.0001、P = 0.0205和P = 0.0140）。值得注意的是，当调整疾病严重程度、常见实验室炎症标志物、缺氧和其他生命体征、人口统计学和一系列合并症时，IL-6和TNF-α血清水平仍然是疾病严重程度和死亡的独立和重要预测因素。这些结果在第二组患者（n = 231）中得到验证。我们建议在COVID-19患者的管理和治疗中应考虑血清IL-6和TNF-α水平，以分层前瞻性临床试验，指导资源分配并为治疗方案提供信息。
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.
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DOI：
10.1038/mtna.2014.49
发表时间：
2014-10-07
期刊：
Molecular therapy. Nucleic acids
影响因子：
--
作者：
通讯作者：
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理解Kaplan-Meier曲线的实用指南。
影响因子：
3.4
作者：
Rich, Jason T.;Neely, J. Gail;Paniello, Randal C.;Voelker, Courtney C. J.;Nussenbaum, Brian;Wang, Eric W.
通讯作者：
Wang, Eric W.
影响因子：
20.3
作者：
Nishimoto, Norihiro;Terao, Kimio;Kakehi, Takahiro
通讯作者：
Kakehi, Takahiro
影响因子：
2.1
作者：
Berger, Moritz;Schmid, Matthias;Beyersmann, Jan
通讯作者：
Beyersmann, Jan
影响因子：
10.5
作者：
Fehr AR;Channappanavar R;Perlman S
通讯作者：
Perlman S