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Infect Dis Rep . Absence of "Cytokine Storm" in Hospitalized COVID-19 Patients: A Retrospective Cohort Study

tetano

Editor, Senior Moderator
Infect Dis Rep


. 2021 Apr 19;13(2):377-387.
doi: 10.3390/idr13020036.
Absence of "Cytokine Storm" in Hospitalized COVID-19 Patients: A Retrospective Cohort Study


Maeghan L Ciampa[SUP] 1 [/SUP], Thomas A O'Hara[SUP] 1 [/SUP], Constance L Joel[SUP] 1 [/SUP], Melinda M Gleaton[SUP] 2 [/SUP], Kirti K Tiwari[SUP] 3 [/SUP], Daniel M Boudreaux[SUP] 3 [/SUP], Balakrishna M Prasad[SUP] 3 [/SUP]



Affiliations

Abstract

Background: A rapidly growing number of publications cite "cytokine storm" as a contributing factor in coronavirus disease 2019 (COVID-19) pathology. However, a few recent reports led to questioning of "cytokine storm" theory in COVID-19. This study's primary goal is to determine if exaggerated cytokine response in the range of a "cytokine storm" develops during the initial weeks of hospitalization in COVID-19 patients. Methods: Five proinflammatory cytokines reported to be involved in "cytokine storm" and elevated in COVID-19 (IL-6, IL-8, TNF-?, MCP-1, and IP-10) were analyzed in COVID-19, influenza (with "cytokine storm": CS), and burn injury patients. The effect of dexamethasone use on cytokine response in COVID-19 was also analyzed. Results: None of the five cytokines in COVID-19 patients reached the lower threshold (95% CI) of the influenza (CS) group at any point during the study period. Furthermore, mean concentrations of all five cytokines in the influenza (CS) group and IL-6, IL-8, TNF-? in the burn group were significantly greater than in COVID-19 patients (p < 0.01). Dexamethasone treatment did not significantly alter the concentrations of any of the cytokines analyzed. Conclusions: Exaggerated cytokine response similar to "cytokine storm" was not observed in COVID-19 patients during two weeks of hospitalization.

Keywords: COVID-19; coronavirus; cytokine; dexamethasone; immunosuppressant; interleukin.
 
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