Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study.
BMJ Open
; 10(11): e041471, 2020 11 30.
Article
in English
| MEDLINE | ID: covidwho-951588
ABSTRACT
OBJECTIVE:
To delineate the characteristics and clinical significance of plasma inflammatory cytokines altered in COVID-19.DESIGN:
Retrospective, single-centre cohort study.SETTING:
Tongji Hospital in Wuhan, China.PARTICIPANTS:
Among a cohort of 308 patients with a diagnosis of COVID-19, 138 patients died while 170 patients recovered and were discharged from the hospital. The data were collected until 27 February 2020. PRIMARY AND SECONDARY OUTCOMEMEASURES:
Clinical characteristics and laboratory findings were obtained from electronic medical records using data collection forms.RESULTS:
The percentage of patients with elevated interleukin 2 receptor (IL-2R), IL-6, IL-8, IL-10 and tumour necrosis factor (TNF) increased with severity of disease (p<0.0001 for all). IL-2R (p<0.0001), IL-6 (p<0.0001), IL-8 (p=0.0001), IL-10 (p<0.0001) and TNF (p<0.0001) were also twofold to 20-fold higher in patients who died compared with those who recovered. Also, IL-6 and IL-10 increased in both the progressive patient groups moderate (p=0.0026) and severe (p<0.0001). In multivariate analysis, higher levels of IL-2R (OR 1.001, 95% CI 1.000 to 1.002, p=0.031) and IL-6 (OR 1.013, 95% CI 1.003 to 1.024, p=0.015) on admission were associated with increasing odds of in-hospital death, independent of other covariates, including severity of disease and lymphocyte count.CONCLUSION:
Increased proinflammatory and anti-inflammatory cytokines, including IL-2R, IL-6, IL-8, TNF and IL-10, showed an obvious association with both COVID-19 severity and in-hospital mortality. Thus, our study indicates that cytokines are valuable in predicting the severity of COVID-19 and helps in distinguishing critically ill patients from the less affected ones.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Severity of Illness Index
/
Cytokines
/
Hospital Mortality
/
Critical Illness
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
English
Journal:
BMJ Open
Year:
2020
Document Type:
Article
Affiliation country:
Bmjopen-2020-041471
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