Emir Yonas1, Idrus Alwi2, Raymond Pranata3, Ian Huang4, Michael Anthonius Lim5, Muhammad Yamin6, Sally Aman Nasution7, Siti Setiati8, Salim S Virani9. 1. Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia. Electronic address: e_yonas@windowslive.com. 2. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. Electronic address: Idrus_a@hotmail.com. 3. Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Electronic address: raymond_pranata@hotmail.com. 4. Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia; Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia. Electronic address: ianhuang2108@gmail.com. 5. Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Electronic address: lim.michael.a@gmail.com. 6. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. Electronic address: muhyam511@gmail.com. 7. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. Electronic address: sanasution@yahoo.com. 8. Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Electronic address: S_setiati@yahoo.com. 9. Michael E. DeBakey Veterans Affairs Medical Center & Baylor College of Medicine, Houston, TX, USA. Electronic address: virani@bcm.edu.
Abstract
BACKGROUND AND AIMS: COVID 19 pneumonia commonly leads to ARDS. The occurrence of ARDS in COVID 19 patients is thought to occur secondary to an exaggerated immunologic response. In this meta-analysis, we aim to comprehensively study the various levels of immunological parameters in patients with COVID 19. MATERIALS AND METHODS: We performed a systematic literature search from PubMed, EuropePMC, SCOPUS, Cochrane Central Database, and medRxiv with the search terms, "COVID-19" and "Interleukin". The outcome of interest was prognosis in COVID 19 patients. RESULTS: We performed meta analysis of 16 studies. Higher counts of CD4 and CD8 with Lower Levels of TNF-a, IL2R, IL6, IL8 were observed on patients with good prognosis compared to patients with poor prognosis; -0.57 (pg/mL) (-1.10, -0.04, p = 0.04), (I2 91%, p < 0.001); -579.84 (U/mL) (-930.11, -229.57, p < 0.001), (I2 96%, p < 0.001); -1.49 (pg/mL) (-1.97, -1.01, p < 0.001), (I2 94%, p < 0.001); -0.80 (pg/mL) (-1.21, -0.40, p < 0.001), (I2 79%, p < 0.001); -2.51 (pg/mL) (-3.64, -1.38, p < 0.00001), (I2 98%, p < 0.001) respectively. Meta-regression showed age and hypertension (coefficient: 1.99, and -1.57, p = 0.005, and 0.006) significantly influenced association between IL-6 and poor outcome. CONCLUSION: Elevated immune response to coronavirus occurs in COVID 19 patients. Higher counts of CD4 and CD8 were seen in patients with good prognosis compared to patients with poor prognosis, with Lower levels of TNF-a, IL2R, IL6, IL8, were observed in patients with good prognosis compared to patients with poor prognosis.
BACKGROUND AND AIMS: COVID 19 pneumonia commonly leads to ARDS. The occurrence of ARDS in COVID 19patients is thought to occur secondary to an exaggerated immunologic response. In this meta-analysis, we aim to comprehensively study the various levels of immunological parameters in patients with COVID 19. MATERIALS AND METHODS: We performed a systematic literature search from PubMed, EuropePMC, SCOPUS, Cochrane Central Database, and medRxiv with the search terms, "COVID-19" and "Interleukin". The outcome of interest was prognosis in COVID 19patients. RESULTS: We performed meta analysis of 16 studies. Higher counts of CD4 and CD8 with Lower Levels of TNF-a, IL2R, IL6, IL8 were observed on patients with good prognosis compared to patients with poor prognosis; -0.57 (pg/mL) (-1.10, -0.04, p = 0.04), (I2 91%, p < 0.001); -579.84 (U/mL) (-930.11, -229.57, p < 0.001), (I2 96%, p < 0.001); -1.49 (pg/mL) (-1.97, -1.01, p < 0.001), (I2 94%, p < 0.001); -0.80 (pg/mL) (-1.21, -0.40, p < 0.001), (I2 79%, p < 0.001); -2.51 (pg/mL) (-3.64, -1.38, p < 0.00001), (I2 98%, p < 0.001) respectively. Meta-regression showed age and hypertension (coefficient: 1.99, and -1.57, p = 0.005, and 0.006) significantly influenced association between IL-6 and poor outcome. CONCLUSION: Elevated immune response to coronavirus occurs in COVID 19patients. Higher counts of CD4 and CD8 were seen in patients with good prognosis compared to patients with poor prognosis, with Lower levels of TNF-a, IL2R, IL6, IL8, were observed in patients with good prognosis compared to patients with poor prognosis.
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