Aberrant cytokine expression in COVID-19 patients: Associations between cytokines and disease severity

Cytokine. 2021 Jul:143:155523. doi: 10.1016/j.cyto.2021.155523. Epub 2021 Mar 31.

Abstract

Cytokines play pleiotropic, antagonistic, and collaborative in viral disease. The high morbidity and mortality of coronavirus disease 2019 (COVID-19) make it a significant threat to global public health. Elucidating its pathogenesis is essential to finding effective therapy. A retrospective study was conducted on 71 patients hospitalized with COVID-19. Data on cytokines, T lymphocytes, and other clinical and laboratory characteristics were collected from patients with variable disease severity. The effects of cytokines on the overall survival (OS) and event-free survival (EFS) of patients were analyzed. The critically severe and severe patients had higher infection indexes and significant multiple organ function abnormalities than the mild patients (P < 0.05). IL-6 and IL-10 were significantly higher in the critically severe patients than in the severe and mild patients (P < 0.05). IL-6 and IL-10 were closely associated with white blood cells, neutrophils, T lymphocyte subsets, D-D dimer, blood urea nitrogen, complement C1q, procalcitonin C-reactive protein. Moreover, the IL-6 and IL-10 levels were closely correlated to dyspnea and dizziness (P < 0.05). The patients with higher IL-10 levels had shorter OS than the group with lower levels (P < 0.05). The older patients with higher levels of single IL-6 or IL-10 tended to have shorter EFS (P < 0.05), while the patients who had more elevated IL-6 and IL-10 had shorter OS (P < 0.05). The Cox proportional hazard model revealed that IL-6 was the independent factor affecting EFS. IL-6 and IL-10 play crucial roles in COVID-19 prognosis.

Keywords: COVID-19; Cytokines; Disease severity; Survival; T lymphocyte.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aging
  • Blood Coagulation Factors / analysis
  • COVID-19 / blood*
  • COVID-19 / mortality
  • COVID-19 / pathology*
  • COVID-19 / therapy
  • Cytokine Release Syndrome / pathology
  • Female
  • Humans
  • Interleukin-10 / blood*
  • Interleukin-6 / blood*
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2 / immunology
  • Severity of Illness Index
  • Survival Analysis
  • T-Lymphocyte Subsets / cytology
  • T-Lymphocyte Subsets / immunology*
  • Thromboembolism / pathology
  • Treatment Outcome

Substances

  • Blood Coagulation Factors
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Interleukin-10