Sang Jenniffer C, Musyoki Stanslaus K, Injera Wilfred E, Karani Lucy W, Maiyoh Geoffrey K
Department of Medical Laboratory Sciences, School of Health Sciences, Kisii University, Kisii, Kenya; Department of Laboratory and pathology Services, Moi Teaching and Referral Hospital, P.O. Box 3 - 30100, Eldoret, Kenya.
Department of Medical Laboratory Sciences, School of Health Sciences, South Eastern Kenya University, P.O. Box 170-90200, Kitui, Kenya.
Cytokine. 2025 Jun;190:156917. doi: 10.1016/j.cyto.2025.156917. Epub 2025 Mar 20.
COVID-19 manifests with a wide range of severities, from asymptomatic to critical conditions. Immunological profiles in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may serve as early indicators of disease severity, aiding in prioritizing patient care.
Archived patient plasma samples were retrieved from the Molecular Lab Bio-repository, ensuring equal representation of males, females, and various disease severities. Socio-demographic and disease severity data were obtained from patient health records. Levels of pro-inflammatory cytokines (interferon-gamma [IFN-γ], tumor necrosis factor-alpha [TNF-α], interleukin-2 [IL-2], and interleukin-17 [IL-17]) and anti-inflammatory cytokines (interleukin-4 [IL-4], interleukin-6 [IL-6], and interleukin-10 [IL-10]) were measured using the BD FACSCalibur flow cytometer. Data analysis involved comparing cytokine levels across different disease severities, with demographic data expressed as means ± standard deviation (SD). Statistical significance was set at P ≤ 0.05.
The mean ages for males and females were 49.6 ± 22.7 and 48.4 ± 23.7, respectively. Mean ages for disease severity categories were 33 ± 19 (asymptomatic), 45.2 ± 21.5 (moderate), 56.8 ± 18.7 (severe), and 61.95 ± 22 (critical). Comorbidities were present in 25 % of patients, with cardiovascular disease (41 %) and pulmonary disease (31 %) being the most common. Predominant symptoms in critical patients included dyspnea (63 %) and myalgia (60 %), while rhinorrhea (46.2 %) and chest pain (45.7 %) were common in severe cases. Gastrointestinal symptoms were observed only in severe and critical groups. Levels of the pro-inflammatory cytokines (IFN-γ, TNF-α, and IL-17) increased linearly with disease severity. Among anti-inflammatory cytokines, IL-6 and IL-10 levels also rose significantly with increasing severity.
Levels of TNF-α, IL-17, and IL-6 correlated with disease severity and may serve as prognostic biomarkers. Advanced age and underlying comorbidities were independently associated with higher disease severity.
新型冠状病毒肺炎（COVID-19）表现出广泛的严重程度，从无症状到危重症。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测呈阳性的患者的免疫谱可作为疾病严重程度的早期指标，有助于确定患者护理的优先级。
从分子实验室生物样本库中获取存档的患者血浆样本，确保男性、女性以及各种疾病严重程度的患者样本数量均衡。社会人口统计学和疾病严重程度数据来自患者健康记录。使用BD FACSCalibur流式细胞仪测量促炎细胞因子（干扰素-γ[IFN-γ]、肿瘤坏死因子-α[TNF-α]、白细胞介素-2[IL-2]和白细胞介素-17[IL-17]）和抗炎细胞因子（白细胞介素-4[IL-4]、白细胞介素-6[IL-6]和白细胞介素-10[IL-10]）的水平。数据分析包括比较不同疾病严重程度下的细胞因子水平，人口统计学数据以均值±标准差（SD）表示。设定P≤0.05为具有统计学意义。
男性和女性的平均年龄分别为49.6±22.7岁和48.4±23.7岁。疾病严重程度分类的平均年龄分别为33±19岁（无症状）、45.2±21.5岁（中度）、56.8±18.7岁（重度）和61.95±22岁（危重症）。25%的患者存在合并症，其中心血管疾病（41%）和肺部疾病（31%）最为常见。危重症患者的主要症状包括呼吸困难（63%）和肌痛（60%），而重度患者常见流涕（46.2%）和胸痛（45.7%）。仅在重度和危重症组观察到胃肠道症状。促炎细胞因子（IFN-γ、TNF-α和IL-17）的水平随疾病严重程度呈线性增加。在抗炎细胞因子中，IL-6和IL-10水平也随着严重程度的增加而显著升高。
TNF-α、IL-17和IL-6的水平与疾病严重程度相关，可能作为预后生物标志物。高龄和潜在合并症与较高的疾病严重程度独立相关。
