Functional immunoparalysis characterized by elevated Interleukin-10 and Interleukin-10- to-Lymphocyte Count Ratio is associated with severe disease and poor outcomes in coronavirus disease 2019 (COVID-19)
Functional immunoparalysis characterized by elevated Interleukin-10 and Interleukin-10- to-Lymphocyte Count Ratio is associated with severe disease and poor outcomes in coronavirus disease 2019 (COVID-19)
ABSTRACT ObjectivesSevere coronavirus disease 2019 (COVID-19) is associated with a dysregulated immune state, called cytokine storm. While research has focused on the hyperinflammation, little research has been performed on the compensatory anti-inflammatory response which if severe may lead to a state of functional immunoparalysis. The aim of this study was to evaluate the anti-inflammatory response to COVID-19, by assessing interleukin-10 (IL-10) and IL-10/lymphocyte count ratio and their association with patient outcomes. MethodsAdult patients presenting to the emergency department (ED) with laboratory-confirmed COVID-19 were recruited. The primary endpoint was peak COVID-19 severity within 30 days of index ED visit. Additional endpoints included COVID-19 severity at ED disposition, development of severe acute kidney injury (AKI) or secondary bacterial infections. ResultsA total of 52 COVID-19 patients were enrolled. IL-10 and IL-10/lymphocyte count were significantly higher in patients with severe disease at both time points (all p<0.05), as well as in those who developed severe AKI and secondary bacterial infection (all p≤0.01). In multivariable analysis, a one-unit increase in IL-10 was associated with 42% increased odds of severe COVID-19 (p=0.031), whilst a one-unit increase IL-10/lymphocyte ratio was also associated with 32% increase in odds of severe COVID-19 (p=0.013). ConclusionsThe hyperinflammatory response to COVID-19 is accompanied by a simultaneous anti-inflammatory response, which is associated with poor outcomes and may increase the risk of secondary bacterial infections. IL-10 and IL-10/lymphocyte ratio at ED presentation were independent predictors of COVID-19 severity. Functional immunoparalysis in COVID-19 requires further investigation to enable more precise immunomodulatory therapy against SARS-CoV-2.
Benoit Stefanie W.、Vikse Jens、Rose James、Benoit Justin L.、de Oliveira Maria Helena Santos、Pulvino Christina、Henry Brandon Michael、Berger Brandon A.、Lippi Giuseppe、Hoehn Jonathan
Division of Nephrology and Hypertension, Cincinnati Children?ˉs Hospital Medical Center||Department of Pediatrics, University of Cincinnati, College of MedicineClinical Immunology Unit, Stavanger University HospitalDivision of Nephrology and Hypertension, Cincinnati Children?ˉs Hospital Medical CenterDepartment of Emergency Medicine, University of CincinnatiDepartment of Statistics, Federal University of ParanaDepartment of Emergency Medicine, University of CincinnatiCardiac Intensive Care Unit, The Heart Institute, Cincinnati Children?ˉs Hospital Medical CenterDepartment of Emergency Medicine, University of CincinnatiSection of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University of VeronaDepartment of Emergency Medicine, University of Cincinnati
医药卫生理论医学研究方法内科学
SARS-CoV-2cytokinesanti-inflammatory responseimmunoparalysisoutcomes
Benoit Stefanie W.,Vikse Jens,Rose James,Benoit Justin L.,de Oliveira Maria Helena Santos,Pulvino Christina,Henry Brandon Michael,Berger Brandon A.,Lippi Giuseppe,Hoehn Jonathan.Functional immunoparalysis characterized by elevated Interleukin-10 and Interleukin-10- to-Lymphocyte Count Ratio is associated with severe disease and poor outcomes in coronavirus disease 2019 (COVID-19)[EB/OL].(2025-03-28)[2025-04-29].https://www.medrxiv.org/content/10.1101/2020.09.28.20203398.点此复制
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