Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis
Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis
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DOI：
10.1172/jci.insight.140289
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发表时间：
2020-09-03
期刊：
影响因子：
8
通讯作者：
Rogers, Angela J.
中科院分区：
文献类型：
--
作者：
Wilson, Jennifer G.;Simpson, Laura J.;Rogers, Angela J.
背景资料。新冠肺炎患者中炎性细胞因子水平升高与预后不良有关。然而，目前尚不清楚这些水平与重症患者中观察到的急性呼吸窘迫综合征或其他原因引起的脓毒症患者的比较。方法：我们使用Luminex法检测了住院的新冠肺炎患者血浆中76种细胞因子的表达，以及来自急性呼吸窘迫综合征和脓毒症患者的库存血浆样本。我们的分析集中于检测与细胞因子风暴相关的6种细胞因子(IL-1β、IL-1RA、IL-6、IL-8、IL-18和肿瘤坏死因子-α)在中、重度新冠肺炎患者和急性呼吸窘迫综合征或脓毒症患者之间的差异。结果：15例新冠肺炎住院患者，其中9例危重患者，与12例急性呼吸窘迫综合征或脓毒症危重患者进行比较。在这个较小的队列中，新冠肺炎患者和患有急性呼吸窘迫综合征或脓毒症的危重患者之间的IL-1β、IL-1RA、IL-6、IL-8、IL-18和肿瘤坏死因子-α的基线水平差异无统计学意义。在许多3期研究中，免疫抑制疗法在急性呼吸窘迫综合征中的广泛应用都失败了；在未经选择的新冠肺炎患者中使用这些疗法可能是没有根据的。
BACKGROUND. Elevated levels of inflammatory cytokines have been associated with poor outcomes among COVID-19 patients. It is unknown, however, how these levels compare with those observed in critically ill patients with acute respiratory distress syndrome (ARDS) or sepsis due to other causes.METHODS. We used a Luminex assay to determine expression of 76 cytokines from plasma of hospitalized COVID-19 patients and banked plasma samples from ARDS and sepsis patients. Our analysis focused on detecting statistical differences in levels of 6 cytokines associated with cytokine storm (IL-1 beta, IL-1RA, IL-6, IL-8, IL-18, and TNF-alpha) between patients with moderate COVID-19, severe COVID-19, and ARDS or sepsis.RESULTS. Fifteen hospitalized COVID-19 patients, 9 of whom were critically ill, were compared with critically ill patients with ARDS (n = 12) or sepsis (n = 16). There were no statistically significant differences in baseline levels of IL-1 beta, IL-1RA, IL-6, IL-8, IL-18, and TNF-alpha between patients with COVID-19 and critically ill controls with ARDS or sepsis.CONCLUSION. Levels of inflammatory cytokines were not higher in severe COVID-19 patients than in moderate COVID-19 or critically ill patients with ARDS or sepsis in this small cohort. Broad use of immunosuppressive therapies in ARDS has failed in numerous Phase 3 studies; use of these therapies in unselected patients with COVID-19 may be unwarranted.