Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study
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 di...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e041471.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850063036682862592 |
|---|---|
| author | Fan He Tao Wang Liu Hu Qing Quan Liu Anying Cheng Yiru Wang Haifang Li Xuecheng Zhao |
| author_facet | Fan He Tao Wang Liu Hu Qing Quan Liu Anying Cheng Yiru Wang Haifang Li Xuecheng Zhao |
| author_sort | Fan He |
| collection | DOAJ |
| description | 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 outcome measures 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. |
| format | Article |
| id | doaj-art-d2926a00043d49e1a60ec58b2e6aa9f1 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d2926a00043d49e1a60ec58b2e6aa9f12025-08-20T02:49:46ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-041471Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort studyFan He0Tao Wang1Liu Hu2Qing Quan Liu3Anying Cheng4Yiru Wang5Haifang Li6Xuecheng Zhao7Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaHealth Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Hepatobiliary Surgery, People’s Hospital of Yangxin County, Huangshi, Hubei, ChinaDepartment of Cardiology, China-Japan Friendship Hospital, Beijing, ChinaObjective 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 outcome measures 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.https://bmjopen.bmj.com/content/10/11/e041471.full |
| spellingShingle | Fan He Tao Wang Liu Hu Qing Quan Liu Anying Cheng Yiru Wang Haifang Li Xuecheng Zhao Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study BMJ Open |
| title | Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study |
| title_full | Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study |
| title_fullStr | Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study |
| title_full_unstemmed | Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study |
| title_short | Cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19): a retrospective cohort study |
| title_sort | cytokines and their relationship with the severity and prognosis of coronavirus disease 2019 covid 19 a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/10/11/e041471.full |
| work_keys_str_mv | AT fanhe cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT taowang cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT liuhu cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT qingquanliu cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT anyingcheng cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT yiruwang cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT haifangli cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy AT xuechengzhao cytokinesandtheirrelationshipwiththeseverityandprognosisofcoronavirusdisease2019covid19aretrospectivecohortstudy |