Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients

ObjectiveA critical role in coronavirus disease 2019 (COVID-19) pathogenesis is played by immune dysregulation that leads to a generalized uncontrolled multisystem inflammatory response, caused by overproduction of proinflammatory cytokines, known as “a cytokine storm” (CS), strongly associated with...

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Autores principales:	Sergey G. Shcherbak, Anna Yu Anisenkova, Sergei V. Mosenko, Oleg S. Glotov, Alexander N. Chernov, Svetlana V. Apalko, Stanislav P. Urazov, Evgeny Y. Garbuzov, Dmitry N. Khobotnikov, Olga A. Klitsenko, Evdokia M. Minina, Zakhar P. Asaulenko
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	COVID-19 cytokine storm clinical and biochemical prognostic factors patients prognostic scale Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/394e092e5db542638cdf62bd8e9e5bff
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spelling	oai:doaj.org-article:394e092e5db542638cdf62bd8e9e5bff2021-11-10T07:24:41ZBasic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients1664-322410.3389/fimmu.2021.745515https://doaj.org/article/394e092e5db542638cdf62bd8e9e5bff2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.745515/fullhttps://doaj.org/toc/1664-3224ObjectiveA critical role in coronavirus disease 2019 (COVID-19) pathogenesis is played by immune dysregulation that leads to a generalized uncontrolled multisystem inflammatory response, caused by overproduction of proinflammatory cytokines, known as “a cytokine storm” (CS), strongly associated with a severe course of disease. The aim of this study is to identify prognostic biomarkers for CS development in COVID-19 patients and integrate them into a prognostic score for CS-associated risk applicable to routine clinical practice.Materials and MethodsThe authors performed a review of 458 medical records from COVID-19 patients (241 men and 217 women aged 60.0 ± 10.0) who received treatment in the St. Petersburg State Budgetary Institution of Healthcare City Hospital 40 (City Hospital 40, St. Petersburg), from Apr. 18, 2020 to Nov. 21, 2020. The patients were split in two groups: one group included 100 patients with moderate disease symptoms; the other group included 358 patients with progressive moderately severe, severe, and extremely severe disease. The National Early Warning Score (NEWS) score was used alongside with clinical assessment, chest computed tomographic (CT) scans, electrocardiography (ECG), and lab tests, like ferritin, C-reactive protein (CRP), interleukin (IL)-6, lactate dehydrogenase (LDH), and D-dimer.ResultsThe basic risk factors for cytokine storms in COVID-19 patients are male gender, age over 40 years, positive test result for replicative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, absolute lymphocyte count, dynamics in the NEWS score, as well as LDH, D-dimer, ferritin, and IL-6 levels. These clinical and instrumental findings can be also used as laboratory biomarkers for diagnosis and dynamic monitoring of cytokine storms. The suggested prognostic scale (including the NEWS score dynamics; serum IL-6 greater than 23 pg/ml; serum CRP 50 mg/L or greater; absolute lymphocyte count less than 0.72 × 109/L; positive test result for replicative coronavirus (SARS-CoV-2) RNA; age 40 years and over) is a useful tool to identify patients at a high risk for cytokine storm, requiring an early onset of anti-inflammatory therapy.Sergey G. ShcherbakSergey G. ShcherbakAnna Yu AnisenkovaAnna Yu AnisenkovaSergei V. MosenkoSergei V. MosenkoOleg S. GlotovOleg S. GlotovAlexander N. ChernovAlexander N. ChernovSvetlana V. ApalkoStanislav P. UrazovEvgeny Y. GarbuzovDmitry N. KhobotnikovOlga A. KlitsenkoEvdokia M. MininaZakhar P. AsaulenkoZakhar P. AsaulenkoFrontiers Media S.A.articleCOVID-19cytokine stormclinical and biochemical prognostic factorspatientsprognostic scaleImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 cytokine storm clinical and biochemical prognostic factors patients prognostic scale Immunologic diseases. Allergy RC581-607
spellingShingle	COVID-19 cytokine storm clinical and biochemical prognostic factors patients prognostic scale Immunologic diseases. Allergy RC581-607 Sergey G. Shcherbak Sergey G. Shcherbak Anna Yu Anisenkova Anna Yu Anisenkova Sergei V. Mosenko Sergei V. Mosenko Oleg S. Glotov Oleg S. Glotov Alexander N. Chernov Alexander N. Chernov Svetlana V. Apalko Stanislav P. Urazov Evgeny Y. Garbuzov Dmitry N. Khobotnikov Olga A. Klitsenko Evdokia M. Minina Zakhar P. Asaulenko Zakhar P. Asaulenko Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients
description	ObjectiveA critical role in coronavirus disease 2019 (COVID-19) pathogenesis is played by immune dysregulation that leads to a generalized uncontrolled multisystem inflammatory response, caused by overproduction of proinflammatory cytokines, known as “a cytokine storm” (CS), strongly associated with a severe course of disease. The aim of this study is to identify prognostic biomarkers for CS development in COVID-19 patients and integrate them into a prognostic score for CS-associated risk applicable to routine clinical practice.Materials and MethodsThe authors performed a review of 458 medical records from COVID-19 patients (241 men and 217 women aged 60.0 ± 10.0) who received treatment in the St. Petersburg State Budgetary Institution of Healthcare City Hospital 40 (City Hospital 40, St. Petersburg), from Apr. 18, 2020 to Nov. 21, 2020. The patients were split in two groups: one group included 100 patients with moderate disease symptoms; the other group included 358 patients with progressive moderately severe, severe, and extremely severe disease. The National Early Warning Score (NEWS) score was used alongside with clinical assessment, chest computed tomographic (CT) scans, electrocardiography (ECG), and lab tests, like ferritin, C-reactive protein (CRP), interleukin (IL)-6, lactate dehydrogenase (LDH), and D-dimer.ResultsThe basic risk factors for cytokine storms in COVID-19 patients are male gender, age over 40 years, positive test result for replicative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, absolute lymphocyte count, dynamics in the NEWS score, as well as LDH, D-dimer, ferritin, and IL-6 levels. These clinical and instrumental findings can be also used as laboratory biomarkers for diagnosis and dynamic monitoring of cytokine storms. The suggested prognostic scale (including the NEWS score dynamics; serum IL-6 greater than 23 pg/ml; serum CRP 50 mg/L or greater; absolute lymphocyte count less than 0.72 × 109/L; positive test result for replicative coronavirus (SARS-CoV-2) RNA; age 40 years and over) is a useful tool to identify patients at a high risk for cytokine storm, requiring an early onset of anti-inflammatory therapy.
format	article
author	Sergey G. Shcherbak Sergey G. Shcherbak Anna Yu Anisenkova Anna Yu Anisenkova Sergei V. Mosenko Sergei V. Mosenko Oleg S. Glotov Oleg S. Glotov Alexander N. Chernov Alexander N. Chernov Svetlana V. Apalko Stanislav P. Urazov Evgeny Y. Garbuzov Dmitry N. Khobotnikov Olga A. Klitsenko Evdokia M. Minina Zakhar P. Asaulenko Zakhar P. Asaulenko
author_facet	Sergey G. Shcherbak Sergey G. Shcherbak Anna Yu Anisenkova Anna Yu Anisenkova Sergei V. Mosenko Sergei V. Mosenko Oleg S. Glotov Oleg S. Glotov Alexander N. Chernov Alexander N. Chernov Svetlana V. Apalko Stanislav P. Urazov Evgeny Y. Garbuzov Dmitry N. Khobotnikov Olga A. Klitsenko Evdokia M. Minina Zakhar P. Asaulenko Zakhar P. Asaulenko
author_sort	Sergey G. Shcherbak
title	Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients
title_short	Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients
title_full	Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients
title_fullStr	Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients
title_full_unstemmed	Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients
title_sort	basic predictive risk factors for cytokine storms in covid-19 patients
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/394e092e5db542638cdf62bd8e9e5bff
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Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients

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