Cytokine signatures of end organ injury in COVID-19

Cytokine signatures of end organ injury in COVID-19

Abstract Increasing evidence has shown that Coronavirus disease 19 (COVID-19) severity is driven by a dysregulated immunologic response. We aimed to assess the differences in inflammatory cytokines in COVID-19 patients compared to contemporaneously hospitalized controls and then analyze the relation...

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Autores principales: Luis G. Gómez-Escobar, Katherine L. Hoffman, Justin J. Choi, Alain Borczuk, Steven Salvatore, Sergio L. Alvarez-Mulett, Manuel D. Galvan, Zhen Zhao, Sabrina E. Racine-Brzostek, He S. Yang, Heather W. Stout-Delgado, Mary E. Choi, Augustine M. K. Choi, Soo Jung Cho, Edward J. Schenck
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Publicado: Nature Portfolio 2021
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Science
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Acceso en línea:https://doaj.org/article/de6315cd729b4ccca1809ce8dcb1cf1d
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spelling oai:doaj.org-article:de6315cd729b4ccca1809ce8dcb1cf1d2021-12-02T17:40:45ZCytokine signatures of end organ injury in COVID-1910.1038/s41598-021-91859-z2045-2322https://doaj.org/article/de6315cd729b4ccca1809ce8dcb1cf1d2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91859-zhttps://doaj.org/toc/2045-2322Abstract Increasing evidence has shown that Coronavirus disease 19 (COVID-19) severity is driven by a dysregulated immunologic response. We aimed to assess the differences in inflammatory cytokines in COVID-19 patients compared to contemporaneously hospitalized controls and then analyze the relationship between these cytokines and the development of Acute Respiratory Distress Syndrome (ARDS), Acute Kidney Injury (AKI) and mortality. In this cohort study of hospitalized patients, done between March third, 2020 and April first, 2020 at a quaternary referral center in New York City we included adult hospitalized patients with COVID-19 and negative controls. Serum specimens were obtained on the first, second, and third hospital day and cytokines were measured by Luminex. Autopsies of nine cohort patients were examined. We identified 90 COVID-19 patients and 51 controls. Analysis of 48 inflammatory cytokines revealed upregulation of macrophage induced chemokines, T-cell related interleukines and stromal cell producing cytokines in COVID-19 patients compared to the controls. Moreover, distinctive cytokine signatures predicted the development of ARDS, AKI and mortality in COVID-19 patients. Specifically, macrophage-associated cytokines predicted ARDS, T cell immunity related cytokines predicted AKI and mortality was associated with cytokines of activated immune pathways, of which IL-13 was universally correlated with ARDS, AKI and mortality. Histopathological examination of the autopsies showed diffuse alveolar damage with significant mononuclear inflammatory cell infiltration. Additionally, the kidneys demonstrated glomerular sclerosis, tubulointerstitial lymphocyte infiltration and cortical and medullary atrophy. These patterns of cytokine expression offer insight into the pathogenesis of COVID-19 disease, its severity, and subsequent lung and kidney injury suggesting more targeted treatment strategies.Luis G. Gómez-EscobarKatherine L. HoffmanJustin J. ChoiAlain BorczukSteven SalvatoreSergio L. Alvarez-MulettManuel D. GalvanZhen ZhaoSabrina E. Racine-BrzostekHe S. YangHeather W. Stout-DelgadoMary E. ChoiAugustine M. K. ChoiSoo Jung ChoEdward J. SchenckNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-15 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Luis G. Gómez-Escobar
Katherine L. Hoffman
Justin J. Choi
Alain Borczuk
Steven Salvatore
Sergio L. Alvarez-Mulett
Manuel D. Galvan
Zhen Zhao
Sabrina E. Racine-Brzostek
He S. Yang
Heather W. Stout-Delgado
Mary E. Choi
Augustine M. K. Choi
Soo Jung Cho
Edward J. Schenck
Cytokine signatures of end organ injury in COVID-19
description Abstract Increasing evidence has shown that Coronavirus disease 19 (COVID-19) severity is driven by a dysregulated immunologic response. We aimed to assess the differences in inflammatory cytokines in COVID-19 patients compared to contemporaneously hospitalized controls and then analyze the relationship between these cytokines and the development of Acute Respiratory Distress Syndrome (ARDS), Acute Kidney Injury (AKI) and mortality. In this cohort study of hospitalized patients, done between March third, 2020 and April first, 2020 at a quaternary referral center in New York City we included adult hospitalized patients with COVID-19 and negative controls. Serum specimens were obtained on the first, second, and third hospital day and cytokines were measured by Luminex. Autopsies of nine cohort patients were examined. We identified 90 COVID-19 patients and 51 controls. Analysis of 48 inflammatory cytokines revealed upregulation of macrophage induced chemokines, T-cell related interleukines and stromal cell producing cytokines in COVID-19 patients compared to the controls. Moreover, distinctive cytokine signatures predicted the development of ARDS, AKI and mortality in COVID-19 patients. Specifically, macrophage-associated cytokines predicted ARDS, T cell immunity related cytokines predicted AKI and mortality was associated with cytokines of activated immune pathways, of which IL-13 was universally correlated with ARDS, AKI and mortality. Histopathological examination of the autopsies showed diffuse alveolar damage with significant mononuclear inflammatory cell infiltration. Additionally, the kidneys demonstrated glomerular sclerosis, tubulointerstitial lymphocyte infiltration and cortical and medullary atrophy. These patterns of cytokine expression offer insight into the pathogenesis of COVID-19 disease, its severity, and subsequent lung and kidney injury suggesting more targeted treatment strategies.
format article
author Luis G. Gómez-Escobar
Katherine L. Hoffman
Justin J. Choi
Alain Borczuk
Steven Salvatore
Sergio L. Alvarez-Mulett
Manuel D. Galvan
Zhen Zhao
Sabrina E. Racine-Brzostek
He S. Yang
Heather W. Stout-Delgado
Mary E. Choi
Augustine M. K. Choi
Soo Jung Cho
Edward J. Schenck
author_facet Luis G. Gómez-Escobar
Katherine L. Hoffman
Justin J. Choi
Alain Borczuk
Steven Salvatore
Sergio L. Alvarez-Mulett
Manuel D. Galvan
Zhen Zhao
Sabrina E. Racine-Brzostek
He S. Yang
Heather W. Stout-Delgado
Mary E. Choi
Augustine M. K. Choi
Soo Jung Cho
Edward J. Schenck
author_sort Luis G. Gómez-Escobar
title Cytokine signatures of end organ injury in COVID-19
title_short Cytokine signatures of end organ injury in COVID-19
title_full Cytokine signatures of end organ injury in COVID-19
title_fullStr Cytokine signatures of end organ injury in COVID-19
title_full_unstemmed Cytokine signatures of end organ injury in COVID-19
title_sort cytokine signatures of end organ injury in covid-19
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/de6315cd729b4ccca1809ce8dcb1cf1d
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