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Published on: October 25, 2024
IL-17A in COVID-19 Cases: a meta-analysis
Sukayna Fadlallah1, Marcel S Sham Eddin1, Elias A Rahal2
1Department of Experimental Pathology, Microbiology and Immunology, American University of Beirut, Beirut, Lebanon.
Introduction:
Numerous reviews, commentaries and opinion pieces have suggested targeting IL-17A as part of managing Coronavirus disease 2019 (COVID-19), the notorious pandemic caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). IL-17A is a proinflammatory cytokine attributed with homeostatic roles but that is also involved in autoimmune disease pathogenesis. While some studies have reported an increase in IL-17A in COVID-19 cases, no significant associations were found by others. Hence, we undertook this meta-analysis to study serum IL-17A levels in COVID-19 patients in relation to disease severity.
Methodology:
Multiple databases were systematically reviewed for literature published on the topic from January 1, 2019 to April 30, 2021. A random effects model was used to calculate weighted mean differences (WMDs) and 95% confidence interval (CIs) as well as the t2 and I2 statistics for heterogeneity analysis.
Results:
We report that IL-17A increases in COVID-19 subjects irrespective of disease severity compared to controls [WMD = 2.51 pg/ml (95% CI 1.73-3.28), p < 0.00001]. It is also higher in patients with moderate disease compared to controls [WMD = 2.41 pg/ml (95% CI:1.40-3.43), p < 0.00001] as well as higher in patients with severe COVID-19 [WMD = 4.13 pg/ml (95% CI:1.65-6.60), p = 0.001]. While the increase in serum levels in subjects with severe disease over those with moderate disease was statistically significant, the association was not as robust as the other comparisons [WMD = 2.07 pg/ml (95% CI:0.20-3.95), p = 0.03]. Variable heterogeneity was observed in the various analyses with no significant publication bias detected.
Conclusions:
Hence, IL-17A may be of relevance when considering management approaches to COVID-19.
Insights
This meta-analysis found that Interleukin-17A (IL-17A) levels are elevated in COVID-19 patients, regardless of disease severity. Higher IL-17A concentrations correlate with moderate and severe Coronavirus disease 2019, suggesting its potential role in disease management.
Area of Science:
- Immunology
- Infectious Diseases
- Biochemistry
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has prompted research into its underlying mechanisms.
- Interleukin-17A (IL-17A), a pro-inflammatory cytokine, has been implicated in autoimmune diseases and its role in COVID-19 remains debated.
- Conflicting reports exist regarding elevated IL-17A levels in COVID-19 patients.
Purpose of the Study:
- To conduct a meta-analysis investigating serum IL-17A levels in COVID-19 patients.
- To determine the association between IL-17A levels and COVID-19 disease severity.
- To evaluate the potential of IL-17A as a target for COVID-19 management.
Main Methods:
- Systematic review of multiple databases for studies published between January 1, 2019, and April 30, 2021.
- Application of a random effects model to calculate weighted mean differences (WMDs) and 95% confidence intervals (CIs).
- Analysis of heterogeneity using t2 and I2 statistics and assessment for publication bias.
Main Results:
- Serum IL-17A levels were significantly increased in COVID-19 subjects compared to controls (WMD = 2.51 pg/ml).
- Elevated IL-17A levels were observed in both moderate (WMD = 2.41 pg/ml) and severe (WMD = 4.13 pg/ml) COVID-19 cases.
- A statistically significant, though less robust, increase in IL-17A was noted in severe cases compared to moderate cases (WMD = 2.07 pg/ml).
Conclusions:
- IL-17A levels are elevated in COVID-19 patients, irrespective of disease severity.
- The findings suggest IL-17A may be a relevant biomarker and potential therapeutic target for COVID-19.
- Further research is warranted to elucidate the precise role of IL-17A in COVID-19 pathogenesis and management.
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