住院轻症和重症 COVID-19 患者的早期细胞因子特征：一项前瞻性观察研究。
Early Cytokine Signatures of Hospitalized Mild and Severe COVID-19 Patients: A Prospective Observational Study.
作者信息
Alfadda Assim A, Siddiqui Khalid, Rafiullah Mohamed, AlKhowaiter Mohammad, Alotaibi Naif, Alzahrani Musa, Binkhamis Khalifa, Youssef Amira M, Altalhi Haifa, Almaghlouth Ibrahim, Alarifi Mohammed, Albanyan Saleh, Alosaimi Mohammed F, Isnani Arthur, Nawaz Shaik S, Alayed Khalid
机构信息
Department of Internal Medicine, College of Medicine, and King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
出版信息
J Inflamm Res. 2023 Jun 22;16:2631-2643. doi: 10.2147/JIR.S408663. eCollection 2023.
BACKGROUND
The severe manifestation of coronavirus disease 2019 (COVID-19) is known to be mediated by several cytokines and chemokines. The study aimed to compare the early cytokine profile of mild and severe COVID-19 patients to that with COVID-19-like symptoms and tested negative for Severe Acute Respiratory Syndrome Coronavirus-2 in the Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) test.
METHODS
This was a prospective, observational study on COVID-19 patients admitted to King Khalid University Hospital, King Saud University Medical City from June to November 2020. Clinical and biochemical data were collected from hospital charts. Blood samples were collected at the time of hospital admission to measure cytokines. A Cytokine and Growth Factor High-Sensitivity Array was used to quantitatively measure cytokines.
RESULTS
The study included 202 RT-PCR-positive individuals and 61 RT-PCR-negative individuals. C-Reactive protein (CRP) and Interleukin-10 (IL-10) levels were found significantly elevated in the RT-PCR positive group compared to the RT-PCR negative group (=0.001). Patients with severe COVID-19 had significantly longer median hospital stays than those with mild COVID-19 cases (7 vs 6 days). They also had higher CRP and Vascular Endothelial Growth Factor (VEGF) levels and lower Interleukin-4 (IL-4) levels compared to the mild cases. CRP, interleukin-6, IL-10, VEGF, and Monocyte Chemoattractant Protein-1 (MCP-1) levels were significantly elevated in men and IL-10 was significantly higher and interleukin-8 was significantly lower in women compared to negative controls. Elevated Interferon-ɣ (IFN-γ) and IL-10 levels were seen in mild COVID-19 cases and elevated level of MCP-1 was seen in severe COVID-19 cases when categorized according to the length of stay in the hospital.
CONCLUSION
CRP and IL-10 levels were elevated in the RT-PCR positive group. People with severe COVID-19 had higher CRP and VEGF levels and lower IL-4 levels. Elevated IFN-γ and IL-10 levels were seen in mild COVID-19 cases and elevated level of MCP-1 was seen in severe COVID-19 cases when categorized according to the length of stay in the hospital.
背景
已知2019冠状病毒病（COVID-19）的严重表现是由多种细胞因子和趋化因子介导的。本研究旨在比较轻型和重型COVID-19患者与有COVID-19样症状且逆转录聚合酶链反应（RT-PCR）检测严重急性呼吸综合征冠状病毒2呈阴性的患者的早期细胞因子谱。
方法
这是一项对2020年6月至11月入住沙特国王大学医学院哈利德国王大学医院的COVID-19患者进行的前瞻性观察研究。从医院病历中收集临床和生化数据。入院时采集血样以检测细胞因子。使用细胞因子和生长因子高灵敏度阵列定量检测细胞因子。
结果
该研究纳入了202名RT-PCR阳性个体和61名RT-PCR阴性个体。与RT-PCR阴性组相比，RT-PCR阳性组的C反应蛋白（CRP）和白细胞介素-10（IL-10）水平显著升高（P=0.001）。重型COVID-19患者的中位住院时间显著长于轻型COVID-19患者（7天对6天）。与轻型病例相比，他们的CRP和血管内皮生长因子（VEGF）水平也更高，白细胞介素-4（IL-4）水平更低。与阴性对照组相比，男性的CRP、白细胞介素-6、IL-10、VEGF和单核细胞趋化蛋白-1（MCP-1）水平显著升高，女性的IL-10显著更高，白细胞介素-8显著更低。根据住院时间分类，轻型COVID-19病例中干扰素-γ（IFN-γ）和IL-10水平升高，重型COVID-19病例中MCP-1水平升高。
结论
RT-PCR阳性组的CRP和IL-10水平升高。重型COVID-19患者的CRP和VEGF水平更高，IL-4水平更低。根据住院时间分类，轻型COVID-19病例中IFN-γ和IL-10水平升高，重型COVID-19病例中MCP-1水平升高。
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