Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis

BACKGROUNDElevated levels of inflammatory cytokines have been associated with poor outcomes among COVID-19 patients. It is unknown, however, how these levels compare with those observed in critically ill patients with acute respiratory distress syndrome (ARDS) or sepsis due to other causes.METHODSWe...

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Published in:JCI insight Vol. 5; no. 17
Main Authors: Wilson, Jennifer G., Simpson, Laura J., Ferreira, Anne-Maud, Rustagi, Arjun, Roque, Jonasel, Asuni, Adijat, Ranganath, Thanmayi, Grant, Philip M., Subramanian, Aruna, Rosenberg-Hasson, Yael, Maecker, Holden T., Holmes, Susan P., Levitt, Joseph E., Blish, Catherine A., Rogers, Angela J.
Format: Journal Article
Language:English
Published: United States American Society for Clinical Investigation 03.09.2020
American Society for Clinical investigation
Subjects:
Adult
Aged
Biomarkers
Case-Control Studies
Clinical Medicine
Coronavirus Infections - blood
Coronavirus Infections - immunology
COVID-19
Cytokine Release Syndrome - blood
Cytokine Release Syndrome - immunology
Cytokine storm
Cytokines - blood
Cytokines - immunology
Disease
Female
Hospitalization
Humans
IL-1β
Immunosuppressive agents
Infectious diseases
Inflammation
Interleukin 1 receptor antagonist
Interleukin 1 Receptor Antagonist Protein - blood
Interleukin 1 Receptor Antagonist Protein - immunology
Interleukin 1 receptors
Interleukin 18
Interleukin 6
Interleukin 8
Interleukin-18 - blood
Interleukin-18 - immunology
Interleukin-1beta - blood
Interleukin-1beta - immunology
Interleukin-6 - blood
Interleukin-6 - immunology
Interleukin-8 - blood
Interleukin-8 - immunology
Male
Middle Aged
Pandemics
Patients
Plasma
Pneumonia, Viral - blood
Pneumonia, Viral - immunology
Respiratory distress syndrome
Respiratory Distress Syndrome - blood
Respiratory Distress Syndrome - immunology
Sepsis
Sepsis - blood
Sepsis - immunology
Severity of Illness Index
Statistical analysis
Tumor Necrosis Factor-alpha - blood
Tumor Necrosis Factor-alpha - immunology
Tumor necrosis factor-α
Ventilation
Ventilators
COVID-19
Cytokines
Inflammation
ISSN:2379-3708, 2379-3708
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Summary:BACKGROUNDElevated levels of inflammatory cytokines have been associated with poor outcomes among COVID-19 patients. It is unknown, however, how these levels compare with those observed in critically ill patients with acute respiratory distress syndrome (ARDS) or sepsis due to other causes.METHODSWe used a Luminex assay to determine expression of 76 cytokines from plasma of hospitalized COVID-19 patients and banked plasma samples from ARDS and sepsis patients. Our analysis focused on detecting statistical differences in levels of 6 cytokines associated with cytokine storm (IL-1β, IL-1RA, IL-6, IL-8, IL-18, and TNF-α) between patients with moderate COVID-19, severe COVID-19, and ARDS or sepsis.RESULTSFifteen hospitalized COVID-19 patients, 9 of whom were critically ill, were compared with critically ill patients with ARDS (n = 12) or sepsis (n = 16). There were no statistically significant differences in baseline levels of IL-1β, IL-1RA, IL-6, IL-8, IL-18, and TNF-α between patients with COVID-19 and critically ill controls with ARDS or sepsis.CONCLUSIONLevels of inflammatory cytokines were not higher in severe COVID-19 patients than in moderate COVID-19 or critically ill patients with ARDS or sepsis in this small cohort. Broad use of immunosuppressive therapies in ARDS has failed in numerous Phase 3 studies; use of these therapies in unselected patients with COVID-19 may be unwarranted.FUNDINGFunding was received from NHLBI K23 HL125663 (AJR); The Bill and Melinda Gates Foundation OPP1113682 (AJR and CAB); Burroughs Wellcome Fund Investigators in the Pathogenesis of Infectious Diseases #1016687 NIH/NIAID U19AI057229-16; Stanford Maternal Child Health Research Institute; and Chan Zuckerberg Biohub (CAB).
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Authorship note: JGW, LJS, and AMF are co–first authors.
ISSN:2379-3708
2379-3708
DOI:10.1172/jci.insight.140289