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Mohammedsaeed, W., Alahmadey, Z. Z., & Manzoor, N. (2023). Serum Cytokine Levels As Critical Parameters in Early Diagnosis of Disease Progression in COVID-19: A Pilot Study. Sudan Journal of Medical Sciences (SJMS), 18(2), 190–202. https://doi.org/10.18502/sjms.v18i2.13603
https://doi.org/10.18502/sjms.v18i2.13603
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authors
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Walaa Mohammedsaeed
Walaa Mohammedsaeed
Clinical Biochemistry, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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Ziab Zakey Alahmadey
Ziab Zakey Alahmadey
Laboratory Department, Ohud Hospital Madinah, Saudi Arabia
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Nikhat Manzoor
Nikhat Manzoor
Medical Mycology Lab, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
Published Date
- Jun 30, 2023
Serum Cytokine Levels As Critical Parameters in Early Diagnosis of Disease Progression in COVID-19: A Pilot Study
Abstract
Background: The severity of Coronavirus disease 2019 (COVID-19) has been proposed to be associated with cytokine dysregulation. A significant number of patients become serious and need intensive care in hospitals.
Methods: The concentrations of cytokines interleukin (IL-6, IL-10) and tumor necrosis factor (TNF) were estimated using enzyme-linked immunosorbent assay (ELISA) in serum samples of 60 adult patients infected with SARS-CoV-2 along with 50 healthy controls of the same age. The mean age of the subjects was 50-52 years and included an equal number of males and females. The patients were further grouped as severe (38 patients) and non-severe cases (22 patients).
Results: The mean serum cytokine levels were significantly higher in the COVID-19 patients than in the healthy controls. IL-6 was excessively elevated in comparison to IL-10 and TNF. Comparative analysis of severe versus non-severe cases revealed only slight alterations in the cytokine levels: IL-6 being the most elevated in severe cases. The concentration of the liver enzyme ALT was higher than AST in both severe and non-severe cases. The mean concentration of serum electrolytes (Na, K, and Ca) did not vary much between the patients and healthy controls.
Conclusion: There was a significant positive correlation between the levels of cytokines serum biomarkers in COVID-19 patients. It may be suggested that early detection of cytokines, especially IL-6 and serum biomarkers can help predict disease prognosis and severity in COVID-19 patients.
Keywords:
COVID-19, Cytokines, disease severity, diagnosis, liver function, kidney function
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[4] Wang, C., Horby, P. W., Hayden, F. G., & Gao, G. F. (2020). A novel coronavirus outbreak of global health concern. Lancet, 395, 470–473.
[5] Lopes-Pacheco, M., Silva, P. L., Cruz, F. F., Battaglini, D., Robba, C., Pelosi, P., Morales, M. M., Caruso Neves, C., & Rocco, P. R. M. (2021). Pathogenesis of multiple organ injury in COVID-19 and potential therapeutic strategies. Frontiers in Physiology, 12, 593223.
[6] Nicholls, J. M., Poon, L. L., Lee, K. C., Ng, W. F., Lai, S. T., Leung, C. Y., Chu, C. M., Hui, P. K., Mak, K. L., Lim, W., Yan, K. W., Chan, K. H., Tsang, N. C., Guan, Y., Yuen, K. Y., & Peiris, J. S. (2003). Lung pathology of fatal severe acute respiratory syndrome. Lancet, 361, 1773–1778.
[7] Zhang, Y., Li, J., Zhan, Y., Wu, L., Yu, X., Zhang, W., Ye, L., Xu, S., Sun, R., Wang, Y., & Lou, J. (2004). Analysis of serum cytokines in patients with severe acute respiratory syndrome. Infection and Immunity, 72, 4410–4415.
[8] Velazquez-Salinas, L., Verdugo-Rodriguez, A., Rodriguez, L. L., & Borca, M. V. (2019). The role of interleukin 6 during viral infections. Frontiers in Microbiology, 10, 1057.
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[10] Kany, S., Vollrath, J. T., & Relja, B. (2019). Cytokines in inflammatory disease. International Journal of Molecular Sciences, 20, 6008.
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[12] Ye, Q., Wang, B., & Mao, J. (2020). The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. The Journal of Infection, 80, 607–613.
[13] Sinha, P., Matthay, M. A., & Calfee, C. S. (2020). Is a “cytokine storm” relevant to COVID-19? JAMA Internal Medicine, 180, 1152–1154.
[14] Rismanbaf, A., & Zarei, S. (2020). Liver and kidney injuries in COVID-19 and their effects on drug therapy; a Letter to Editor. Archives of Academic Emergency Medicine, 8, e17.
[15] Martinez, M. A., & Franco, S. (2021). Impact of COVID-19 in liver disease progression. Hepatology Communications, 5, 1138–1150.
[16] Clark, R., Waters, B., & Stanfill, A. G. (2021). Elevated liver function tests in COVID-19: Causes, clinical evidence, and potential treatments. The Nurse Practitioner, 46, 21–26.
[17] Ghahramani, S., Tabrizi, R., Lankarani, K. B., Kashani, S. M. A., Rezaei, S., Zeidi, N., Akbari, M., Heydari, S. T., Akbari, H., Nowrouzi-Sohrabi, P., & Ahmadizar, F. (2020). Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: A systematic review and meta-analysis. European Journal of Medical Research, 25, 30.
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[22] Forbester, J. L., & Humphreys, I. R. (2021). Genetic influences on viral-induced cytokine responses in the lung. Mucosal Immunology, 14, 14–25.
[23] Melo, A. K. G., Milby, K. M., Caparroz, A. L. M. A., Pinto, A. C. P. N., Santos, R. R. P., Rocha, A. P., Ferreira, G. A., Souza, V. A., Valadares, L. D. A., Vieira, R. M. R. A., Pileggi, G. S., & Trevisani, V. F. M. (2021). Biomarkers of cytokine storm as red flags for severe and fatal COVID-19 cases: A living systematic review and meta-analysis. PLoS One, 16, e0253894.
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[29] Islam, H., Chamberlain, T. C., Mui, A. L., & Little, J. P. (2021). Elevated interleukin-10 levels in COVID-19: Potentiation of pro-inflammatory responses or impaired anti-inflammatory action? Frontiers in Immunology, 12, 677008.
[30] Alfano, G., Ferrari, A., Fontana, F., Perrone, R., Mori, G., Ascione, E., Magistroni, R., Venturi, G., Pederzoli, S., Margiotta, G., Romeo, M., Piccinini, F., Franceschi, G., Volpi, S., Faltoni, M., Ciusa, G., Bacca, E., Tutone, M., Raimondi, A., . . . Guaraldi, G., & the Modena Covid-19 Working Group (MoCo19). (2021). Hypokalemia in patients with COVID-19. Clinical and Experimental Nephrology, 25, 401–409. https://doi.org/10.1007/s10157-020-01996-4