需要体外膜肺氧合支持的重症严重急性呼吸综合征冠状病毒2型感染中的细胞因子谱。

Cytokine profiles in severe SARS-CoV-2 infection requiring extracorporeal membrane oxygenation support.

作者信息

Kaman Kelsey, Azmy Veronica, Chichra Astha, Britto-Leon Clemente, Price Christina

机构信息

Yale University Department of Internal Medicine, New Haven, CT, 06513, USA.

VA Connecticut Health Systems, West Haven, CT, 06516, USA.

出版信息

Respir Med Case Rep. 2021;33:101376. doi: 10.1016/j.rmcr.2021.101376. Epub 2021 Mar 3.

DOI:10.1016/j.rmcr.2021.101376

PMID:33680800

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7925237/

Abstract

It has been postulated that the underlying pathophysiology of COVID-19 is mediated by cytokine storm resulting in a hyperinflammatory state. A similar kind of cytokine-storm has been described in individuals undergoing veno-venous extracorporeal membrane oxygenation (VV ECMO) support. There is therefore concern that initiation of VV ECMO support among COVID19 patients could further exacerbate this dysregulated inflammatory response. In this prospective cohort study, we describe the clinical course and cytokine fluctuations in eight subjects treated with VV ECMO for management of refractory respiratory failure from COVID19. Among all eight patients, cytokine elevations were noted among Interleukin 6 (IL-6), Interleukin 10 (IL-10), and Interleukin 2 Receptor (CD25) soluble (sIL2R). Although further research is necessary, among our cohort of patients it did not appear that initiation of VV ECMO worsened cytokine storm.

摘要

据推测，新冠病毒疾病（COVID-19）的潜在病理生理学是由细胞因子风暴介导的，从而导致一种过度炎症状态。在接受静脉-静脉体外膜肺氧合（VV ECMO）支持的个体中也描述过类似的细胞因子风暴。因此，有人担心在COVID-19患者中启动VV ECMO支持可能会进一步加剧这种失调的炎症反应。在这项前瞻性队列研究中，我们描述了8名接受VV ECMO治疗以管理COVID-19难治性呼吸衰竭的受试者的临床过程和细胞因子波动情况。在所有8名患者中，白细胞介素6（IL-6）、白细胞介素10（IL-10）和可溶性白细胞介素2受体（sIL2R，CD25）均出现细胞因子升高。尽管还需要进一步研究，但在我们的患者队列中，启动VV ECMO似乎并没有使细胞因子风暴恶化。