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Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS

Authors :
Francesco Salton
Paola Confalonieri
Giuseppina Campisciano
Rossella Cifaldi
Clara Rizzardi
Daniele Generali
Riccardo Pozzan
Stefano Tavano
Chiara Bozzi
Giulia Lapadula
Gianfranco Umberto Meduri
Marco Confalonieri
Manola Comar
Selene Lerda
Barbara Ruaro
Salton, Francesco
Confalonieri, Paola
Campisciano, Giuseppina
Cifaldi, Rossella
Rizzardi, Clara
Generali, Daniele
Pozzan, Riccardo
Tavano, Stefano
Bozzi, Chiara
Lapadula, Giulia
Meduri, Gianfranco Umberto
Confalonieri, Marco
Comar, Manola
Lerda, Selene
Ruaro, Barbara
Source :
Journal of Clinical Medicine; Volume 11; Issue 11; Pages: 2951
Publication Year :
2022
Publisher :
Multidisciplinary Digital Publishing Institute, 2022.

Abstract

Background. Glucocorticoids (GCs) have been shown to reduce mortality and the need for invasive mechanical ventilation (IMV) in SARS-CoV-2-induced acute respiratory distress syndrome (ARDS). It has been suggested that serum cytokines levels are markers of disease severity in ARDS, although there is only limited evidence of a relationship between the longitudinal cytokine profile and clinical outcomes in patients with SARS-CoV-2-induced ARDS treated with GC. Methods. We conducted a single-center observational study to investigate serial plasma cytokine levels in 17 patients supported with non-invasive ventilation (NIV) in order to compare the response in five patients who progressed to IMV versus 12 patients who continued with NIV alone. All patients received methylprednisolone 80 mg/day continuous infusion until clinical improvement. Results. The study groups were comparable at baseline. All patients survived. Although IL-6 was higher in the NIV group at baseline, several cytokines were significantly higher in the IMV group on day 7 (IL-6, IL-8, IL-9, G-CSF, IP-10, MCP-1, MIP-1α) and 14 (IL-6, IL-8, IL-17, G-CSF, MIP-1α, RANTES). No significant differences were observed between groups on day 28. Conclusions. Patients in the IMV group had higher inflammation levels at intubation than the NIV group, which may indicate a higher resistance to glucocorticoids. Higher GC doses or a longer treatment duration in these patients might have allowed for a better control of inflammation and a better outcome. Further studies are required to define the prognostic value of cytokine patterns, in terms of both GC treatment tailoring and timely initiation of IMV.

Details

Language :
English
ISSN :
20770383
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine; Volume 11; Issue 11; Pages: 2951
Accession number :
edsair.doi.dedup.....2ea6d6a432fd7368dcc93bff09dcc5c8
Full Text :
https://doi.org/10.3390/jcm11112951