Cytokine levels as predictors of mortality in critically ill patients with severe COVID-19 pneumonia : Case-control study nested within a cohort in Colombia
Copyright © 2022 Molina, Botero, Isaza, Cano, López, Hoyos, Correa and Torres..
Background: High levels of different cytokines have been associated in COVID-19 as predictors of mortality; however, not all studies have found this association and its role to cause multi-organ failure and death has not been fully defined. This study aimed to investigate the association of the levels of 10 cytokines with mortality in patients with COVID-19 admitted to the intensive care unit (ICU).
Materials and methods: This is a case-control study nested within a cohort of patients with COVID-19 who were on mechanical ventilation and were not hospitalized for more than 48 h across nine ICUs in Medellín, Colombia. Serum samples were collected upon admission to the ICU and 7 days later and used to measure cytokine levels.
Results: Upon admission, no differences in mortality between the cytokine levels were observed when comparisons were made quantitatively. However, in the multivariate analysis, patients with median IL-1β levels <1.365 pg/ml showed an increase in mortality (OR = 3.1; 1.24<7.71; p = 0.015). On day 7 in the ICU, IL-1β median levels were lower (0.34 vs. 2.41 pg/ml, p = 0.042) and IL-10 higher (2.08 vs. 1.05 pg/ml, p = 0.009) in patients who died. However, in the multivariate analysis, only IL-12p70 was associated with mortality (OR = 0.23; 0.07<0.73; p = 0.012). The mean difference in the levels between day 1 and day 7 decreased in both IFN-γ (3.939 pg/ml, p < 0.039) and in IL-18 (16.312 pg/ml, p < 0.014) in the patients who died. A low IL-1β/IL-10 ratio was associated with mortality on both day 1 and day 7, while an IL-1β/IL-10 ratio below the cut-off on day 7 was associated with decreased survival. The lowest TNFα/IL-10 ratio was associated with mortality only on day 7.
Conclusion: At the time of admission, patients with median IL-1β levels lower than 1.365 pg/ml had increased mortality. An IL-1β/IL-10 ratio <2 at day 7 and IL-12p70 levels >1.666 pg/ml was associated with decreased survival.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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Enthalten in: |
Frontiers in medicine - 9(2022) vom: 08., Seite 1005636 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Molina, Francisco José [VerfasserIn] |
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Links: |
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Themen: |
COVID-19 |
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Anmerkungen: |
Date Revised 19.10.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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doi: |
10.3389/fmed.2022.1005636 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM347650708 |
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520 | |a Copyright © 2022 Molina, Botero, Isaza, Cano, López, Hoyos, Correa and Torres. | ||
520 | |a Background: High levels of different cytokines have been associated in COVID-19 as predictors of mortality; however, not all studies have found this association and its role to cause multi-organ failure and death has not been fully defined. This study aimed to investigate the association of the levels of 10 cytokines with mortality in patients with COVID-19 admitted to the intensive care unit (ICU) | ||
520 | |a Materials and methods: This is a case-control study nested within a cohort of patients with COVID-19 who were on mechanical ventilation and were not hospitalized for more than 48 h across nine ICUs in Medellín, Colombia. Serum samples were collected upon admission to the ICU and 7 days later and used to measure cytokine levels | ||
520 | |a Results: Upon admission, no differences in mortality between the cytokine levels were observed when comparisons were made quantitatively. However, in the multivariate analysis, patients with median IL-1β levels <1.365 pg/ml showed an increase in mortality (OR = 3.1; 1.24<7.71; p = 0.015). On day 7 in the ICU, IL-1β median levels were lower (0.34 vs. 2.41 pg/ml, p = 0.042) and IL-10 higher (2.08 vs. 1.05 pg/ml, p = 0.009) in patients who died. However, in the multivariate analysis, only IL-12p70 was associated with mortality (OR = 0.23; 0.07<0.73; p = 0.012). The mean difference in the levels between day 1 and day 7 decreased in both IFN-γ (3.939 pg/ml, p < 0.039) and in IL-18 (16.312 pg/ml, p < 0.014) in the patients who died. A low IL-1β/IL-10 ratio was associated with mortality on both day 1 and day 7, while an IL-1β/IL-10 ratio below the cut-off on day 7 was associated with decreased survival. The lowest TNFα/IL-10 ratio was associated with mortality only on day 7 | ||
520 | |a Conclusion: At the time of admission, patients with median IL-1β levels lower than 1.365 pg/ml had increased mortality. An IL-1β/IL-10 ratio <2 at day 7 and IL-12p70 levels >1.666 pg/ml was associated with decreased survival | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a SARS-CoV-2 | |
650 | 4 | |a cytokines | |
650 | 4 | |a intensive care units | |
650 | 4 | |a mortality | |
650 | 4 | |a pneumonia | |
700 | 1 | |a Botero, Luz Elena |e verfasserin |4 aut | |
700 | 1 | |a Isaza, Juan Pablo |e verfasserin |4 aut | |
700 | 1 | |a Cano, Luz Elena |e verfasserin |4 aut | |
700 | 1 | |a López, Lucelly |e verfasserin |4 aut | |
700 | 1 | |a Hoyos, Lina Marcela |e verfasserin |4 aut | |
700 | 1 | |a Correa, Elizabeth |e verfasserin |4 aut | |
700 | 1 | |a Torres, Antoni |e verfasserin |4 aut | |
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