Sara Bülow Anderberg1, Tomas Luther2, Malin Berglund3, Rolf Larsson3, Sten Rubertsson2, Miklos Lipcsey4, Anders Larsson3, Robert Frithiof2, Michael Hultström5. 1. Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden. Electronic address: sara.bulow@surgsci.uu.se. 2. Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden. 3. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 4. Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden; Hedenstierna Laboratory, Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. 5. Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden; Department of Medical Cell Biology, Integrative Physiology, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND: The infection caused by SARS CoV-2 has been postulated to induce a cytokine storm syndrome that results in organ failure and even death in a considerable number of patients. However, the inflammatory response in Corona virus disease-19 (Covid-19) and its potential to cause collateral organ damage has not been fully elucidated to date. This study aims to characterize the acute cytokine response in a cohort of critically ill Covid-19 patients. METHOD: 24 adults with PCR-confirmed Covid-19 were included at time of admission to intensive care a median of eleven days after initial symptoms. Eleven adult patients admitted for elective abdominal surgery with preoperative plasma samples served as controls. All patients were included after informed consent was obtained. 27 cytokines were quantified in plasma. The expression of inflammatory mediators was then related to routine inflammatory markers, SAPS3, SOFA score, organ failure and 30-day mortality. RESULTS: A general increase in cytokine expression was observed in all Covid-19 patients. A strong correlation between respiratory failure and IL-1ra, IL-4, IL-6, IL-8 and IP-10 expression was observed. Acute kidney injury development correlated well with increased levels of IL-1ra, IL-6, IL-8, IL-17a, IP-10 and MCP-1. Generally, the cohort demonstrated weaker correlations between cytokine expression and 30-day mortality out of which IL-8 showed the strongest signal in terms of mortality. CONCLUSION: The present study found that respiratory failure, acute kidney injury and 30-day mortality in critically ill Covid-19 patients are associated with moderate increases of a broad range of inflammatory mediators at time of admission.
BACKGROUND: The infection caused by SARS CoV-2 has been postulated to induce a cytokine storm syndrome that results in organ failure and even death in a considerable number of patients. However, the inflammatory response in Corona virus disease-19 (Covid-19) and its potential to cause collateral organ damage has not been fully elucidated to date. This study aims to characterize the acute cytokine response in a cohort of critically illCovid-19patients. METHOD: 24 adults with PCR-confirmed Covid-19 were included at time of admission to intensive care a median of eleven days after initial symptoms. Eleven adult patients admitted for elective abdominal surgery with preoperative plasma samples served as controls. All patients were included after informed consent was obtained. 27 cytokines were quantified in plasma. The expression of inflammatory mediators was then related to routine inflammatory markers, SAPS3, SOFA score, organ failure and 30-day mortality. RESULTS: A general increase in cytokine expression was observed in all Covid-19patients. A strong correlation between respiratory failure and IL-1ra, IL-4, IL-6, IL-8 and IP-10 expression was observed. Acute kidney injury development correlated well with increased levels of IL-1ra, IL-6, IL-8, IL-17a, IP-10 and MCP-1. Generally, the cohort demonstrated weaker correlations between cytokine expression and 30-day mortality out of which IL-8 showed the strongest signal in terms of mortality. CONCLUSION: The present study found that respiratory failure, acute kidney injury and 30-day mortality in critically illCovid-19patients are associated with moderate increases of a broad range of inflammatory mediators at time of admission.
Authors: Rebecca De Lorenzo; Clara Sciorati; Giuseppe A Ramirez; Barbara Colombo; Nicola I Lorè; Annalisa Capobianco; Cristina Tresoldi; Daniela M Cirillo; Fabio Ciceri; Angelo Corti; Patrizia Rovere-Querini; Angelo A Manfredi Journal: PLoS One Date: 2022-04-25 Impact factor: 3.240
Authors: Maria Candida Cesta; Mara Zippoli; Carolina Marsiglia; Elizabeth Marie Gavioli; Flavio Mantelli; Marcello Allegretti; Robert A Balk Journal: Front Pharmacol Date: 2022-01-12 Impact factor: 5.810