Background: Biomarkers to prognosticate the outcomes and guide the treatment of patients with severe coronavirus disease 2019 (COVID-19) are currently required. We aimed to investigate whether the dynamic variation of cytokines was associated with the survival of patients admitted to the intensive care unit (ICU).
Methods: A retrospective study was performed on 40 patients with COVID-19 admitted to the ICU in Wuhan, China. Demographic, clinical, and laboratory variables were collected, and serum cytokines were kinetically assessed. A multivariable-adjusted generalized linear regression model was used to analyze the differences in serum cytokine levels between survivors and non-survivors.
Results: Among the 40 patients included, we found a positive correlation between multiple cytokines. Serum levels of interleukin (IL)-6, IL-10, and tumor necrosis factor alpha (TNFα) in non-survivors were consistently elevated compared to those in the survivors. Kinetic variations in IL-6, IL-8, and IL-10 were associated with a fatal outcome in patients with severe COVID-19, independent of sex, age, absolute lymphocyte count, direct bilirubin, hypertension, chronic obstructive pulmonary disease, and cancer as well as the use of glucocorticoids and tocilizumab.
Conclusions: Dynamic changes in serum IL-6, IL-8, and IL-10 levels were associated with survival in patients in the ICU, and could serve as a predictive biomarker to determine the therapeutic options for patients with severe COVID-19.
Keywords: Coronavirus disease 2019 (COVID-19); IL-10; IL-8; cytokines; interleukin-6 (IL-6).