Increased interleukin-6 and macrophage chemoattractant protein-1 are associated with respiratory failure in COVID-19
Jørgensen, Marthe Jøntvedt; Holter, Jan Cato; Christensen, Erik; Schjalm, Camilla; Tonby, Kristian; Pischke, Soeren; Jenum, Synne; Skeie, Linda Gail; Nur, Sarah; Lind, Andreas; Opsand, Hanne; Enersen, Tone Burvald; Grøndahl, Ragnhild; Hermann, Anne; Dudman, Susanne Gjeruldsen; Müller, Fredrik; Ueland, Thor; Mollnes, Tom Eirik; Aukrust, Pål; Heggelund, Lars; Holten, Aleksander Rygh; Dyrhol-Riise, Anne Ma
Journal article, Peer reviewed
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In SARS-CoV-2 infection there is an urgent need to identify patients that will progress to severe COVID-19 and may benefit from targeted treatment. In this study we analyzed plasma cytokines in COVID-19 patients and investigated their association with respiratory failure (RF) and treatment in Intensive Care Unit (ICU). Hospitalized patients (n = 34) with confirmed COVID-19 were recruited into a prospective cohort study. Clinical data and blood samples were collected at inclusion and after 2–5 and 7–10 days. RF was defined as PaO2/FiO2 ratio (P/F) < 40 kPa. Plasma cytokines were analyzed by a Human Cytokine 27-plex assay. COVID-19 patients with RF and/or treated in ICU showed overall increased systemic cytokine levels. Plasma IL-6, IL-8, G-CSF, MCP-1, MIP-1α levels were negatively correlated with P/F, whereas combinations of IL-6, IP-10, IL-1ra and MCP-1 showed the best association with RF in ROC analysis (AUC 0.79–0.80, p < 0.05). During hospitalization the decline was most significant for IP-10 (p < 0.001). Elevated levels of pro-inflammatory cytokines were present in patients with severe COVID-19. IL-6 and MCP-1 were inversely correlated with P/F with the largest AUC in ROC analyses and should be further explored as biomarkers to identify patients at risk for severe RF and as targets for improved treatment strategies.