Elevated plasma levels of selective cytokines in COVID-19 patients reflect viral load and lung injury

• Published in: National science review Vol. 7; no. 6; pp. 1003 - 1011
• Main Authors: Liu, Yingxia, Zhang, Cong, Huang, Fengming, Yang, Yang, Wang, Fuxiang, Yuan, Jing, Zhang, Zheng, Qin, Yuhao, Li, Xiaoyun, Zhao, Dandan, Li, Shunwang, Tan, Shuguang, Wang, Zhaoqin, Li, Jinxiu, Shen, Chenguang, Li, Jianming, Peng, Ling, Wu, Weibo, Cao, Mengli, Xing, Li, Xu, Zhixiang, Chen, Li, Zhou, Congzhao, Liu, William J, Liu, Lei, Jiang, Chengyu
• Format: Journal Article
• Language: English
• Published: China Oxford University Press 01.06.2020
• Subjects: Special Section: SARS-CoV-2; COVID-19; cytokine storm; 2019-nCoV; IP-10; IL-17
• DOI: 10.1093/nsr/nwaa037
• ISSN: 2095-5138; 2053-714X

Abstract A recent outbreak of pneumonia in Wuhan, China was found to be caused by a 2019 novel coronavirus (2019-nCoV or SARS-CoV-2 or HCoV-19). We previously reported the clinical features of 12 patients with 2019-nCoV infections in Shenzhen, China. To further understand the pathogenesis of COVID-19 and find better ways to monitor and treat the disease caused by 2019-nCoV, we measured the levels of 48 cytokines in the blood plasma of those 12 COVID-19 patients. Thirty-eight out of the 48 measured cytokines in the plasma of 2019-nCoV-infected patients were significantly elevated compared to healthy individuals. Seventeen cytokines were linked to 2019-nCoV loads. Fifteen cytokines, namely M-CSF, IL-10, IFN-α2, IL-17, IL-4, IP-10, IL-7, IL-1ra, G-CSF, IL-12, IFN-γ, IL-1α, IL-2, HGF and PDGF-BB, were strongly associated with the lung-injury Murray score and could be used to predict the disease severity of 2019-nCoV infections by calculating the area under the curve of the receiver-operating characteristics. Our results suggest that 2019-nCoV infections trigger extensive changes in a wide array of cytokines, some of which could be potential biomarkers of disease severity of 2019-nCoV infections. These findings will likely improve our understanding of the immunopathologic mechanisms of this emerging disease. Our results also suggest that modulators of cytokine responses may play a therapeutic role in combating the disease once the functions of these elevated cytokines have been characterized.