Expression of Urine Cytokines in Patients With Severe Pneumonia by SARS-CoV-2

ABSTRACT

Background: Cytokines are involved in the pathogenesis of AKI. The aim of this study was to investigate the urine cytokine profile in patients with severe Pneumonia by SARS-COV-2 and AKI. Method(s) This prospective, longitudinal cohort study was conducted at the National Institute of Respiratory Diseases. We included individuals with Severe pneumonia caused by SARS-CoV-2, >18 years of age;without chronic kidney disease (CKD). AKI was defined as creatinine elevation >0.3 mg/dL in 48 hours or level or TIMP2xIGFBP7 >0.3 ng/ ml. Urine samples were collected in critical areas and frozen at -80, urinary concentrations of TIMP-2 and IGFBP7, NGAL and a panel of 27 cytokines were analized. Statistical Analysis: We first explored wheter cytokine patterns between AKI and NO-AKI groups using the Mann-Whitney test, because of a high level of correlation between our panel of urine cytokines and kidney damage biomarkers we performed Principal Component Analysis (PCA). Statistical significance was set at p<0.05. Result(s) We included 51 patients, 30 were male (58.8%);the median age was 53 years (IQR, 40-61);14 had hypertension (27.5%);16 had diabetes (31.4%);and 21 were obese 41.2%. Significant characteristics as well as serum biochemical laboratories, urine kidney stress biomarkers and cytokines are shown in Table 1. We used Principal Component Analysis to built dimensions associated to AKI outcome. After adjustment by Age and Sex, Dimension 2 composed by IL-5, IP 10 (CXCL10), IGFBP7, MIG (CXCL9) was associated with AKI [aHR 95% CI 19.84 (1.00-399) p= 0.050] as well as Dimension 3 composed by N-GAL, RANTES, IL 8, INF-gamma [aHR 95% CI 21.52 (1.91-242) p=0.013]. Conclusion(s) In our study, some cytokines and biomarkers of kidney damage, such as IGFBP7 and N-Gal, were involved in the development of AKI. (Table Presented).