Prognostic value of cytokines in COVID-19 associated pneumonia

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) is often complicated by cytokine storm syndrome. Although many interleukins (IL) have predictive value, the sensitivity and specificity of a single marker is limited.

AIM: The purpose of the study is to develop an objective and informative cytokine storm scale for assessing the risk of developing a critical course in patients with COVID-19 associated pneumonia.

MATERIALS AND METHODS: A total of 226 cases of COVID-19 were investigated, 36 (16 %) of which were with poor outcomes. The cytokines IL-1b, IL-2, IL-6, IL-8, IL-10, IL-18, TNF-á, IFNá, IFN-ã were studied by enzyme immunoassay, commercial kits manufactured by Vector-Best, RF.

RESULTS: Since IL-6, IL-10, IL-18, and procalcitonin were associated with disease severity and death, these indicators were integrated into a 12-point scale called the cytokine storm scale. The patients who scored more than 6 points had a high risk of a poor outcome of the disease. According to ROC analysis, the area under the curve for the cytokine storm scale was larger than for each of the four markers separately [AUC 0.90 (95% CI 0.8455–0.9592), p < 0.001].

CONCLUSIONS: Thus, the cytokine storm scale system presents superior performance in determining patients with favorable and fatal outcomes to each individual cytokine.

Keywords

SARS-CoV-2 coronavirus / cytokine storm / interleukin 6 / interleukin 18 / interleukin 10 / procalcitonin / cytokine storm scale

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RIGHTS & PERMISSIONS

Tkachenko O.Y., Pervakova M.Y., Lapin S.V., Mazing A.V., Kuznetsova D.A., Moshnikova A.N., Kholopova I.V., Blinova T.V., Surkova E.A., Kulikov A.N., Vorobyev E.A., Vorobyeva S.V., Stanevich O.V., Polushin Y.S., Shlyk I.V., Afanasyev A., Gavrilova E.G., Titova O.N., Volchkova E.V., Potapenko V.G., Khudonogova S.V., Mazurov V.I.