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The Impact of Cytokines on Coagulation Profile in COVID-19 Patients: Controlled for Socio-Demographic, Clinical, and
Milica Milentijević1,2, Nataša Katanić1, Bojan Joksimović3
1Department of Infective Diseases, Faculty of Medicine, University of Pristina Temporarily Settled in Kosovska Mitrovica, 38220 Kosovska Mitrovica, Serbia.
Insights
Pro-inflammatory cytokines like IL-5 and IL-6 are linked to severe COVID-19 coagulation issues. Understanding these links aids in managing COVID-19 patients with clotting abnormalities.
Area of Science:
- Immunology and Infectious Diseases
- Hematology and Coagulation Disorders
Background:
- Severe coagulation abnormalities are frequently observed in patients with COVID-19.
- Pro-inflammatory cytokines play a role in the pathogenesis of COVID-19.
- The interplay between cytokines and coagulation requires further investigation.
Purpose of the Study:
- To investigate the relationship between pro-inflammatory cytokines and coagulation parameters in COVID-19 patients.
- To identify socio-demographic, clinical, and laboratory factors associated with these relationships.
Main Methods:
- Study included 113 hospitalized COVID-19 patients during the second wave in Serbia.
- Data collected included socio-demographic, clinical, and blood sample information.
- Cytokine levels were measured using flow cytometry.
Main Results:
- Longer symptom duration and meropenem use predicted higher D-dimer values.
- Elevated IL-5 correlated with higher INR and prothrombin times.
- Higher IL-6 predicted longer prothrombin times; lower IL-17F and IFN-γ were associated with altered INR and aPTT values, respectively.
Conclusions:
- Significant correlations exist between pro-inflammatory cytokines and coagulation parameters in COVID-19.
- Factors including education, gender, oxygen therapy, symptom duration, meropenem use, and specific cytokines (IL-5, IL-6, IL-17F, IFN-γ) are associated with worse coagulation outcomes.
Abstract:
Background: Severe coagulation abnormalities are common in patients with COVID-19 infection. We aimed to investigate the relationship between pro-inflammatory cytokines and coagulation parameters concerning socio-demographic, clinical, and laboratory characteristics. Methods: Our study included patients hospitalized during the second wave of COVID-19 in the Republic of Serbia. We collected socio-demographic, clinical, and blood-sample data for all patients. Cytokine levels were measured using flow cytometry. Results: We analyzed data from 113 COVID-19 patients with an average age of 58.15 years, of whom 79 (69.9%) were male. Longer duration of COVID-19 symptoms before hospitalization (B = 69.672; p = 0.002) and use of meropenem (B = 1237.220; p = 0.014) were predictive of higher D-dimer values. Among cytokines, higher IL-5 values significantly predicted higher INR values (B = 0.152; p = 0.040) and longer prothrombin times (B = 0.412; p = 0.043), and higher IL-6 (B = 0.137; p = 0.003) predicted longer prothrombin times. Lower IL-17F concentrations at admission (B = 0.024; p = 0.050) were predictive of higher INR values, and lower IFN-γ values (B = -0.306; p = 0.017) were predictive of higher aPTT values. Conclusions: Our findings indicate a significant correlation between pro-inflammatory cytokines and coagulation-related parameters. Factors such as the patient's level of education, gender, oxygen-therapy use, symptom duration before hospitalization, meropenem use, and serum concentrations of IL-5, IL-6, IL-17F, and IFN-γ were associated with worse coagulation-related parameters.
