Cytokine profile in hospitalized patients with COVID-19 of different severity

Abstract

Analysis of cytokine profile markers in conjunction with the clinical manifestations of coronavirus disease 2019 (COVID-19) can provide valuable information about the pathogenetic manifestations of the disease, and therefore, in the future, determine drugs that affect the cytokine storm and have an anti-inflammatory effect.Aim. To identify correlations between the parameters of the developed cytokine profile and the clinical course in hospitalized patients with COVID-19 of different severity.Material and methods. The study included 70 hospitalized patients with a confirmed diagnosis of COVID-19, with a mean age of 58 [50;69] years, including 40 men (57%) and 30 women (43%). The average lung involvement according to computed tomography (CT) at admission was CT-2 [1;3]. Peripheral venous blood was taken at admission, which averaged 7 [6; 8] days from the symptom onset. Standard biochemical parameters were studied, as well as 47 cytokines and chemokines using the Multiplex system (Merck KGaA, Darmstadt, Germany).Results. Correlations was found between the lung involvement degree and the level of IL-8 (r=0,31, p<0,05), IL-15 (r=0,35, p<0,05), IL-18 (r=0,31, p<0,05), MCP-1 (r=0,36, p<0,05), MIG (r=0,50, p<0,05), TNF-α (r=0,41, p<0,05). An inverse correlation was also found in the level of blood oxygen saturation with the same indicators as follows: IL-8 (r=-0,27, p<0,05), IL-15 (r=-0,34, p<0,05), IL-18 (r=-0,31, p<0,05), MCP-1 (r=-0,40, p<0,05), MIG (r=-0,56, p<0,05), TNF-α (r=-0,45, p<0,05). IL-6 levels were significantly elevated in patients with severe COVID-19 (CT3, CT4), while no increase in IL-6 was observed in patients with moderate disease (CT1, CT2). It is noteworthy that in patients with diabetes, the highest values of IL-12, IL-9 were recorded.Conclusion. Hyperinflammatory syndrome in severe COVID-19 is manifested by high levels of IL-6, MIG, MDC, MCP-1, M-CSF, TNF-α, β, IL-8, IL-18, IL-15. With the CT-1 and CT-2, an increase in only the level of IL-18, IL-8 is noted. The identified patterns prove and make it possible to explain a number of systemic inflammatory changes that occur with COVID-19.