ABSTRACT
The pandemic caused by severe acute respiratory syndrome coronavirus 2 and the related disorder i.e. "coronavirus disease 2019" (COVID-19) has encouraged researchers to unravel the molecular mechanism of disease severity. Several lines of evidence support the impact of "cytokine storm" in the pathogenesis of severe forms of the disorder. We aimed to assess expression levels of nine cytokine coding genes in COVID-19 patients admitted in a hospital. We collected clinical data of patients from their medical reports. Then, we assessed expression of genes using real-time PCR. Expression levels of IFN-G, IL-2, IL-4, IL-6, IL-17, TGF-B, IL-8, and IL-1B were significantly higher in COVID-19 patients compared with healthy controls and in both female and male patients compared with sex-matched controls. However, expression level of TNF-A was not different between COVID-19 patients and healthy controls. Expression of none of these cytokines was different between ICU-admitted patients and other patients except for IL-6 whose expression was lower in the former group compared with the latter (ratio of means = 0.33, P value = 4.82E-02). Then, we assessed diagnostic power of cytokine coding genes in differentiating between COVID-19 patients and controls. The area under curve (AUC) values ranged from 0.94 for IFN-G to 1.0 for IL-2 and IL-1B. After combining the transcript levels of all cytokines, AUC, sensitivity, and specificity values reached 100%, 100%, and 99%, respectively. For differentiation between ICU-admitted patients and other patients, IL-4 with AUC value of 0.68 had the best diagnostic power among cytokine coding genes. Expression of none of cytokine coding genes was correlated with the available clinical/demographic data including age, gender, ICU admission, or erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) levels. This study provides further evidence for contribution of "cytokine storm" in the pathobiology of moderate/severe forms of COVID-19.
Subject(s)
COVID-19/blood , Cytokine Release Syndrome/blood , Cytokines/genetics , Pandemics , RNA, Messenger/blood , Adult , Aged , Aged, 80 and over , Blood Sedimentation , C-Reactive Protein/analysis , COVID-19/complications , COVID-19/epidemiology , Case-Control Studies , Critical Care , Cytokine Release Syndrome/etiology , Female , Gene Expression Regulation , Humans , Iran/epidemiology , Male , Middle Aged , RNA, Messenger/genetics , Real-Time Polymerase Chain Reaction , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
Coronavirus disease 2019 (COVID-19) has caused a global pandemic in early 2020. This infectious disorder has a heterogeneous course ranging from asymptomatic disorder to a critical situation needing intensive cares. In the current study, we present a report of affected patients admitted in a single hospital in Iran. Eighty-two hospitalized patients with COVID-19 were assessed. Demographic, clinical, and paraclinical parameters were gathered and statistically analyzed. The median age (IQR) of the patients was 57.32 (45.75, 70) years. At primary evaluation, fever was present in 45.12% of the affected individuals. The most common clinical symptoms were dyspnea (81.71%) and cough (65.85%). Totally, 12 (14.63%) and 14 (17.07%) of patients had low and high WBC counts, respectively. Lymphopenia was detected in 36 (43.9%) of patients, while 6 (7.32%) of patients had lymphocytosis. High levels of Il-6 were detected in 4 (4.88%) of patients. CRP levels were elevated in 69 (84.1%) of patients. The median (IQR) of hospitalization was 7 (5, 9) days. Totally, 26 patients (31%) were hospitalized in ICU. All patients were discharged with good health conditions except for one patient who died. The current study shows the heterogeneous clinical manifestations and paraclinical parameters of COVID-19 patients.
Subject(s)
COVID-19/physiopathology , Cough/physiopathology , Dyspnea/physiopathology , Fever/physiopathology , Lymphocytosis/physiopathology , Lymphopenia/physiopathology , Aged , C-Reactive Protein/metabolism , COVID-19/mortality , COVID-19/therapy , COVID-19/virology , Cough/mortality , Cough/therapy , Cough/virology , Diabetes Mellitus/mortality , Diabetes Mellitus/physiopathology , Diabetes Mellitus/therapy , Diabetes Mellitus/virology , Dyspnea/mortality , Dyspnea/therapy , Dyspnea/virology , Female , Fever/mortality , Fever/therapy , Fever/virology , Hospitals , Humans , Hypertension/mortality , Hypertension/physiopathology , Hypertension/therapy , Hypertension/virology , Iran , Leukocyte Count , Lymphocytosis/mortality , Lymphocytosis/therapy , Lymphocytosis/virology , Lymphopenia/mortality , Lymphopenia/therapy , Lymphopenia/virology , Male , Middle Aged , Obesity/mortality , Obesity/physiopathology , Obesity/therapy , Obesity/virology , Oxygen/therapeutic use , Respiration, Artificial/methods , Retrospective Studies , SARS-CoV-2/pathogenicity , Severity of Illness Index , Survival AnalysisABSTRACT
We are currently involved in the novel coronavirus 2019 (COVID-19) pandemic. A considerable number of COVID-19 infected cases are asymptomatic but they can transmit the disease to others, especially healthcare workers. In this study, we reported 8 incidentally detected cases of COVID-19 pneumonia in chest computed tomography (CT) scan of patients referred to emergency department following multiple trauma without any respiratory symptoms.