Distinct cytokine profiles associated with COVID-19 severity and mortality - CNRS - Centre national de la recherche scientifique Accéder directement au contenu
Article Dans Une Revue Journal of Allergy and Clinical Immunology Année : 2021

Distinct cytokine profiles associated with COVID-19 severity and mortality

Loic Le Guennec

Résumé

Background: Markedly elevated levels of proinflammatory cytokines and defective type-I interferon responses were reported in patients with coronavirus disease 2019 (COVID-19). Objective: We sought to determine whether particular cytokine profiles are associated with COVID-19 severity and mortality. Methods: Cytokine concentrations and severe acute respiratory syndrome coronavirus 2 antigen were measured at hospital admission in serum of symptomatic patients with COVID-19 (N = 115), classified at hospitalization into 3 respiratory severity groups: no need for mechanical ventilatory support (No-MVS), intermediate severity requiring mechanical ventilatory support (MVS), and critical severity requiring extracorporeal membrane oxygenation (ECMO). Principal-component analysis was used to characterize cytokine profiles associated with severity and mortality. The results were thereafter confirmed in an independent validation cohort (N = 86). Results: At time of hospitalization, ECMO patients presented a dominant proinflammatory response with elevated levels of TNF-α, IL-6, IL-8, and IL-10. In contrast, an elevated type-I interferon response involving IFN-α and IFN-β was characteristic of No-MVS patients, whereas MVS patients exhibited both profiles. Mortality at 1 month was associated with higher levels of proinflammatory cytokines in ECMO patients, higher levels of type-I interferons in No-MVS patients, and their combination in MVS patients, resulting in a combined mortality prediction accuracy of 88.5% (risk ratio, 24.3; P < .0001). Severe acute respiratory syndrome coronavirus 2 antigen levels correlated with type-I interferon levels and were associated with mortality, but not with proinflammatory response or severity. Conclusions: Distinct cytokine profiles are observed in association with COVID-19 severity and are differentially predictive of mortality according to oxygen support modalities. These results warrant personalized treatment of COVID-19 patients based on cytokine profiling.
Fichier principal
Vignette du fichier
2021_Dorgham-JACI.pdf (59.36 Mo) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03348684 , version 1 (26-09-2021)

Identifiants

Citer

Karim Dorgham, Paul Quentric, Mehmet Gökkaya, Stéphane Marot, Christophe Parizot, et al.. Distinct cytokine profiles associated with COVID-19 severity and mortality. Journal of Allergy and Clinical Immunology, 2021, 147 (6), pp.2098-2107. ⟨10.1016/j.jaci.2021.03.047⟩. ⟨hal-03348684⟩
49 Consultations
7 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More