COVID 19: in the eye of the cytokine storm

Comment on ‘An inflammatory cytokine signature predicts COVID-19 severity and survival’ was published inNature Medicine 2020; 26: 1636 –1643 (https//doi.org/10.1038/s41591-020-1051-9).Key pointsThe study examined data from 1484 patients hospitalized for suspected or confirmed (n = 1257) COVID-19 at the Mount Sinai Health System in New York between 21 March and 28 April 2020. Serum levels of four inflammatory cytokines were analysed upon admission with a rapid multiplex test: interleukin (IL)-6, IL-8, tumour necrosis factor (TNF)- α, and IL-1β. These results were correlated with clinical and laboratory markers of disease severity and with clinical outcome.Patients were followed from the day of hospitalization to the day of discharge or death (median 8 days). IL-6, IL-8, and TNF- α were significantly (P< 0.0001) elevated in COVID-19 patients compared to healthy donors (n = 9) or patients with cancer treated with chimeric antigen receptor-modified (CAR)-T cells with no cytokine release syndrome (CRS) (n = 151), but lower than in patients with CRS induced by CAR-T cell therapy (n = 121). The vast majority of COVID-19 patients presented with elevated cytokines or cytokine storm.Serum levels above the median value of IL-6 [hazard ratio (HR) 2.23; 1.61 –3.09], IL-8 (HR 1.41; 1.05–1.89), and TNF-α (HR 1.50; 1.09–2.07) at the time of hospitalization were strong and independent predictors of decreased survival after adjusting for demographics and comorbidities.When a...
Source: European Heart Journal - Category: Cardiology Source Type: research