Journal Article

Increased interleukin-6 and macrophage chemoattractant protein-1 are associated with respiratory failure in COVID-19

Hermann, Anne, Heggelund, Lars, Jenum, Synne, Skeie, Linda G., Tonby, Kristian, Pischke, Søren Erik, Muller, Fredrik, Grøndahl, Ragnhild, Christensen, Erik Egeland, Holter, Jan Cato, Schjalm, Camilla, Dyrhol-Riise, Anne Ma, Enersen, Tone Burvald, Lind, Andreas, Nur, Sarah, Opsand, Hanne, Holten, Aleksander Rygh, Ueland, Thor, Mollnes, Tom Eirik, Jøntvedt Jørgensen, Marthe, Aukrust, Pål, Dudman, Susanne

2020

Overview

In SARS-CoV-2 infection there is an urgent need to identify patients that will progress to severe COVID-19 and may benefit from targeted treatment. In this study we analyzed plasma cytokines in COVID-19 patients and investigated their association with respiratory failure (RF) and treatment in Intensive Care Unit (ICU). Hospitalized patients (n = 34) with confirmed COVID-19 were recruited into a prospective cohort study. Clinical data and blood samples were collected at inclusion and after 2–5 and 7–10 days. RF was defined as PaO2/FiO2 ratio (P/F) < 40 kPa. Plasma cytokines were analyzed by a Human Cytokine 27-plex assay. COVID-19 patients with RF and/or treated in ICU showed overall increased systemic cytokine levels. Plasma IL-6, IL-8, G-CSF, MCP-1, MIP-1α levels were negatively correlated with P/F, whereas combinations of IL-6, IP-10, IL-1ra and MCP-1 showed the best association with RF in ROC analysis (AUC 0.79–0.80, p  < 0.05). During hospitalization the decline was most significant for IP-10 ( p  < 0.001). Elevated levels of pro-inflammatory cytokines were present in patients with severe COVID-19. IL-6 and MCP-1 were inversely correlated with P/F with the largest AUC in ROC analyses and should be further explored as biomarkers to identify patients at risk for severe RF and as targets for improved treatment strategies.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 631/250/127 / 692/699/255 / Adult / Aged / Aged, 80 and over / Biomarkers - blood / Chemokine CCL2 - blood / Coronaviruses / COVID-19 / COVID-19 - blood / COVID-19 - complications / Cytokines / Female / Granulocyte colony-stimulating factor / Humanities and Social Sciences / Humans / Inflammation / Interleukin 1 receptor antagonist / Interleukin 1 receptors / Interleukin 6 / Interleukin 8 / Interleukin-6 - blood / IP-10 protein / Macrophages / Male / Middle Aged / Monocyte chemoattractant protein 1 / multidisciplinary / Patients / Prospective Studies / Respiratory failure / Respiratory Insufficiency - blood / Respiratory Insufficiency - etiology / SARS-CoV-2 - metabolism / Science / Science (multidisciplinary) / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index