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Elevated IL-6 and IL-10 Levels as Prognostic Biomarkers in COVID-19 Pneumonia: A Comparative Study in Mexican
Charmina Aguirre-Alvarado1,2, Miguel Ángel Cortes-Vázquez3, Yessica Sara Pérez-González3
1Laboratorio de Bioquímica Farmacológica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11300, Mexico.
Background/Objectives:
Proinflammatory cytokines have been associated with poor prognosis in community-acquired and COVID-19 pneumonia. There is a paucity of reports on the cytokine release syndrome, also called cytokine storm in the Mexican population with pneumonia and COVID-19; therefore, our objective was to compare proinflammatory cytokine levels in Mexican patients without COVID-19 (non-COVID-19) and those with moderate, severe, and critical COVID-19 pneumonia.
Methods:
This study included 30 patients with non-COVID-19 pneumonia and 57 with COVID-19 pneumonia. Disease diagnosis and severity were determined using the radiographic pulmonary edema assessment (RALE) score. Quantification of IL-6, IL-10, and TNF-α was performed using multiplex immunoassays. A receiver operating characteristic curve was constructed to classify subjects with elevated cytokine levels. Logistic regression was used to find associations between elevated cytokine levels and the presence of COVID-19 pneumonia.
Results:
The severity classification of patients with COVID-19 pneumonia was as follows: moderate (n = 20), severe (n = 19), and critical (n = 18). The proinflammatory cytokines IL-6 and IL-10 were significantly increased in COVID-19 patients compared to non-COVID-19 patients (p < 0.005), while TNF-α levels were lower in critically ill patients with COVID-19 pneumonia. High levels of IL-6 and IL-10, adjusted for age, sex, the presence of comorbidities, and the neutrophil-to-lymphocyte ratio (NLR), showed an elevated risk (OR IL-6 = 4.02; OR IL-10 = 9.36) of presenting pneumonia and COVID-19 compared to pneumonia without COVID-19 in patients. Likewise, 61% of COVID-19 patients with elevated proinflammatory cytokines (IL-6 and IL-10) had a fatal outcome.
Conclusions:
Elevated levels of both IL-6 and IL-10 are a differential risk factor for developing COVID-19 pneumonia. These elevated levels were more frequently observed in Mexican COVID-19 pneumonia patients who died at the onset of the COVID-19 pandemic. It is important that they are monitored from initial diagnosis as they may be markers of a fatal outcome in severe and critical COVID-19 patients.
Insights
Elevated levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) indicate a higher risk of developing COVID-19 pneumonia. Monitoring these cytokines is crucial as they are linked to fatal outcomes in severe COVID-19 cases.
Area of Science:
- Immunology
- Infectious Diseases
- Pulmonology
Background:
- Proinflammatory cytokines are linked to poor prognosis in pneumonia, including COVID-19.
- Limited data exists on cytokine release syndrome in Mexican patients with pneumonia and COVID-19.
Purpose of the Study:
- To compare proinflammatory cytokine levels in Mexican patients with and without COVID-19 pneumonia.
- To assess the association between cytokine levels and COVID-19 pneumonia severity and outcomes.
Main Methods:
- Compared cytokine levels (IL-6, IL-10, TNF-α) in 30 non-COVID-19 pneumonia patients and 57 COVID-19 pneumonia patients.
- Used RALE score for disease severity assessment and multiplex immunoassays for cytokine quantification.
- Employed logistic regression and ROC curves to analyze associations between cytokines and COVID-19 pneumonia.
Main Results:
- COVID-19 patients showed significantly higher IL-6 and IL-10 levels (p < 0.005) compared to non-COVID-19 patients.
- Elevated IL-6 and IL-10 levels were associated with an increased risk of COVID-19 pneumonia (OR IL-6 = 4.02; OR IL-10 = 9.36).
- 61% of COVID-19 patients with elevated IL-6 and IL-10 experienced a fatal outcome.
Conclusions:
- Elevated IL-6 and IL-10 serve as differential risk factors for COVID-19 pneumonia in the Mexican population.
- These elevated cytokines were more prevalent in deceased COVID-19 patients during the pandemic's onset.
- Monitoring IL-6 and IL-10 from diagnosis is vital for predicting fatal outcomes in severe and critical COVID-19.
