tetano
Editor, Senior Moderator
Int J Infect Dis
. 2020 Oct 8;S1201-9712(20)32206-2.
doi: 10.1016/j.ijid.2020.10.003. Online ahead of print.
A score combining early detection of cytokines accurately predicts COVID-19 severity and intensive care unit transfer
Carole Nagant[SUP] 1 [/SUP], Fanny Ponthieux[SUP] 2 [/SUP], Julie Smet[SUP] 2 [/SUP], Nicolas Dauby[SUP] 3 [/SUP], Virginie Doyen[SUP] 4 [/SUP], Tatiana Besse-Hammer[SUP] 5 [/SUP], David De Bels[SUP] 6 [/SUP], Evelyne Maillart[SUP] 7 [/SUP], Francis Corazza[SUP] 8 [/SUP]
Affiliations
Abstract
Objectives: We aimed to explore cytokine profile in patients related to Coronavirus Disease 2019 (COVID-19) severity and to establish a predictive cytokine score to discriminate severe from non-severe cases and provide a prognosis parameter for patients that will require intensive care unit (ICU) transfer.
Methods: Serum samples of 63 patients diagnosed with SARS-CoV-2 infection were collected early after hospital admission (day 0-3). Patients were categorized in five groups based on the clinical presentation, the PaO2/FiO2 ratio and the requirement of mechanical ventilation.
Results: Three cytokines, IL-6, IL-8 and IL-10 were markedly higher in severe forms (n = 44) than in non-severe forms (n = 19) (p < 0.005). A score combining levels of these three cytokines (IL-6*IL-8*IL-10) had the highest performance to predict severity: sensitivity of 86.4% (95% CI, 72.4-94.8) and specificity of 94.7% (95% CI, 74.0-99.9) for a cutoff value of 2068 pg/mL. Elevated levels of IL-6, IL-8 and IL-10 were also found in critically ill patients. The combination of IL-6*IL-10 serum levels allowed the highest predictability for ICU transfer: AUC of 0.898 (p < 0.0001).
Conclusion: The combinatorial IL-6*IL-8*IL-10 score at presentation was highly predictive of the progression to a severe form of the disease and could contribute to improve patients triage and to adapt therapeutic strategy within clinical trials more accurately and efficiently.
Keywords: COVID-19; IL-6; disease severity; inflammatory cytokines; intensive care unit; prediction.
. 2020 Oct 8;S1201-9712(20)32206-2.
doi: 10.1016/j.ijid.2020.10.003. Online ahead of print.
A score combining early detection of cytokines accurately predicts COVID-19 severity and intensive care unit transfer
Carole Nagant[SUP] 1 [/SUP], Fanny Ponthieux[SUP] 2 [/SUP], Julie Smet[SUP] 2 [/SUP], Nicolas Dauby[SUP] 3 [/SUP], Virginie Doyen[SUP] 4 [/SUP], Tatiana Besse-Hammer[SUP] 5 [/SUP], David De Bels[SUP] 6 [/SUP], Evelyne Maillart[SUP] 7 [/SUP], Francis Corazza[SUP] 8 [/SUP]
Affiliations
- PMID: 33039609
- PMCID: PMC7544772
- DOI: 10.1016/j.ijid.2020.10.003
Abstract
Objectives: We aimed to explore cytokine profile in patients related to Coronavirus Disease 2019 (COVID-19) severity and to establish a predictive cytokine score to discriminate severe from non-severe cases and provide a prognosis parameter for patients that will require intensive care unit (ICU) transfer.
Methods: Serum samples of 63 patients diagnosed with SARS-CoV-2 infection were collected early after hospital admission (day 0-3). Patients were categorized in five groups based on the clinical presentation, the PaO2/FiO2 ratio and the requirement of mechanical ventilation.
Results: Three cytokines, IL-6, IL-8 and IL-10 were markedly higher in severe forms (n = 44) than in non-severe forms (n = 19) (p < 0.005). A score combining levels of these three cytokines (IL-6*IL-8*IL-10) had the highest performance to predict severity: sensitivity of 86.4% (95% CI, 72.4-94.8) and specificity of 94.7% (95% CI, 74.0-99.9) for a cutoff value of 2068 pg/mL. Elevated levels of IL-6, IL-8 and IL-10 were also found in critically ill patients. The combination of IL-6*IL-10 serum levels allowed the highest predictability for ICU transfer: AUC of 0.898 (p < 0.0001).
Conclusion: The combinatorial IL-6*IL-8*IL-10 score at presentation was highly predictive of the progression to a severe form of the disease and could contribute to improve patients triage and to adapt therapeutic strategy within clinical trials more accurately and efficiently.
Keywords: COVID-19; IL-6; disease severity; inflammatory cytokines; intensive care unit; prediction.