ABSTRACT
Background: Biomarkers that would help prognosticate outcomes and guide treatment of patients with severe coronavirus disease 2019 (COVID-19) are currently required. We aimed to investigate whether the dynamic variation of cytokines was associated with the survival of patients admitted to an intensive care unit (ICU).Methods: A retrospective study was performed on 40 patients with COVID-19 admitted to an ICU in Wuhan, China. Demographic, clinical, and laboratory variables were collected, and serum cytokines were kinetically assessed. A multivariable- adjusted generalized linear regression model was used to evaluate the differences in serum cytokine levels between survivor and non-survivors.Results: Among the 40 patients included, a significant positive correlation was found between multiple cytokines. Serum levels of IL-6, IL-10, and tumor necrosis factor alpha in non-survivors were consistently elevated compared to that of the survivors. Kinetic variations of IL-6, IL-8, and IL-10 were associated with a fatal outcome in severe patients with COVID-19, independent of sex, age, absolute lymphocyte count, direct bilirubin, hypertension, chronic obstructive pulmonary disease, and cancer.Conclusion: Dynamic changes in serum IL-6, IL-8, and IL-10 levels were associated with survival in ICU and could serve as a predictive biomarker in patients with severe COVID-19 to determine therapeutic options.