A Deep Look Into COVID-19 Severity Through Dynamic Changes in Blood Cytokine Levels

An excessive inflammatory response to SARS-CoV-2 is thought to be a major cause of disease severity and mortality in patients with COVID-19. Longitudinal analysis of cytokine release can expand our understanding of the initial stages of disease development and help to identify early markers serving as predictors of disease severity. In this study, we performed a comprehensive analysis of 46 cytokines (including chemokines and growth factors) in the peripheral blood of a large cohort of COVID-19 patients (n=444). The patients were classified into five severity groups. Longitudinal analysis of all patients revealed two groups of cytokines, characterizing the “early” and “late” stages of the disease course and the switch between type 1 and type 2 immunity. We found significantly increased levels of cytokines associated with different severities of COVID-19, and levels of some cytokines were significantly higher during the first three days from symptom onset (DfSO) in patients who eventually required intensive care unit (ICU) therapy. Additionally, we identified nine cytokines, TNF-α, IL-10, MIG, IL-6, IP-10, M-CSF, G-CSF, GM-CSF, and IFN-α2, that can be used as good predictors of ICU requirement at 4-6 DfSO. Copyright © 2021 Kleymenov, Bykonia, Popova, Mazunina, Gushchin, Kolobukhina, Burgasova, Kruzhkova, Kuznetsova, Shidlovskaya, Divisenko, Pochtovyi, Bacalin, Smetanina, Tkachuk, Logunov and Gintsburg.

Kleymenov D.A.1 , Bykonia E.N.1 , Popova L.I.1 , Mazunina E.P.1 , Gushchin V.A.1, 2 , Kolobukhina L.V.1, 3 , Burgasova O.A. 1, 3, 4 , Kruzhkova I.S.3 , Kuznetsova N.A.1 , Shidlovskaya E.V.1 , Divisenko E.V.1 , Pochtovyi A.A.1, 2 , Bacalin V.V. 3, 4 , Smetanina S.V. 3 , Tkachuk A.P.1 , Logunov D.Y.1 , Gintsburg A.L.1, 5
Frontiers Media S.A.
  • 1 Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
  • 2 Department of Virology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russian Federation
  • 3 Moscow Healthcare Department, Moscow, Russian Federation
  • 4 Department of Infectious Diseases, Peoples’ Friendship University of Russia, RUDN University), Moscow, Russian Federation
  • 5 Department of Infectiology and Virology, Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov, First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation
Ключевые слова
COVID-19; cytokines; hyperinflammation; SARS-CoV-2; severity predictors
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