Selection of the Appropriate Control Group Is Essential in Evaluating the Cytokine Storm in COVID-19
- 23 February 2021
- journal article
- research article
- Published by Anticancer Research USA Inc. in In Vivo
- Vol. 35 (2), 1295-1298
- https://doi.org/10.21873/invivo.12381
Abstract
Background/Aim: Lately, studies have reported contradicting results on the cytokine storm seen in critically-ill COVID-19 patients. Depending on the control group used, cytokines have been found to be higher, similar or even lower in COVID-19 compared to critical illnesses associated with elevated cytokine concentrations. However, most of these studies do not take into account critical illness severity. Hence, we decided to compare cytokine levels in critically-ill COVID-19 patients and critically-ill patients of a general intensive care unit (ICU), who did not have sepsis or septic shock, but had an equal disease severity. Patients and Methods: Interleukin (IL)-6, IL-8, IL-10 and tumour necrosis factor-α (TNF-α) were measured on ICU admission in mechanically ventilated, COVID-19 (N=36) and non-COVID-19 (N=30) patients, who had not received dexamethasone, and had equal critical illness severity. Non-COVID-19 patients did not have sepsis or septic shock. Results: In our case control study, circulating IL-6 and IL-10 were lower, while TNF-α and IL-8 levels were higher in critically-ill COVID-19 patients, compared to critically-ill non-COVID-19 patients. Conclusion: It is difficult to infer whether the cytokine storm seen in COVID-19 differs from other critical conditions. It is important to recognize that the conclusions of related studies may depend on control group selection.Keywords
This publication has 8 references indexed in Scilit:
- Classical Drug Digitoxin Inhibits Influenza Cytokine Storm, With Implications for Covid-19 TherapyIn Vivo, 2020
- Cytokine Levels in Critically Ill Patients With COVID-19 and Other ConditionsJAMA, 2020
- Cytokine elevation in severe and critical COVID-19: a rapid systematic review, meta-analysis, and comparison with other inflammatory syndromesThe Lancet Respiratory Medicine, 2020
- Microcirculatory, Endothelial, and Inflammatory Responses in Critically Ill Patients With COVID-19 Are Distinct From Those Seen in Septic Shock: A Case Control StudyShock, 2020
- Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsisJCI Insight, 2020
- Is a “Cytokine Storm” Relevant to COVID-19?JAMA Internal Medicine, 2020
- Elevated biomarkers of endothelial dysfunction/activation at ICU admission are associated with sepsis developmentCytokine, 2014
- Plasma pro- and anti-inflammatory cytokine levels and outcome prediction in unselected critically ill patientsCytokine, 2008