Inflammatory proteins, also known as cytokines, play a crucial role in the immune response.
If this immune response is too strong, a phenomenon known as “cytokine storm,” it can cause harm to the patient.
It has been thought that a cytokine storm contributes to disease severity in patients with COVID-19.
But in a new study, researchers followed the measurement of several important cytokines in patients with COVID-19 and various other severe diseases and found that COVID-19 is not characterized by a cytokine storm.
This finding may have consequences for the treatment of these patients.
The research was conducted by a team at the Radboud university medical center.
The cytokine storm in COVID-19 patients is not clearly defined. In many cases, different cytokines are evaluated and no comparison has been made with other diseases.
Therefore, uncertainty and doubt exist concerning the cytokine storm in these patients.
The team measured the concentration of three essential cytokines in the blood of patients admitted to the IC with several distinct conditions.
They performed these measurements in patients with COVID-19 who had a severe acute respiratory infection (ARDS), patients with bacterial septic shock (with and without ARDS), and patients who had been admitted to the IC after a cardiac arrest or severe trauma.
The cytokines were measured using the same methods for each of the groups of patients.
In the above-described five patient groups, the concentration of tumor necrosis factor-alpha (TNF-α) and interleukins 6 and 8 (IL-6, IL-8) was measured.
The results were remarkable.
The level of cytokines was much less elevated in COVID-19 patients than in patients with septic shock and ARDS.
Compared to patients with septic shock without ARDS, so without the severe pulmonary disease, patients with COVID-19 also displayed markedly lower levels of IL-6 and IL-8.
The cytokine concentrations in COVID-19 patients were similar to those in IC patients with trauma or cardiac arrest, conditions that are not noted for a cytokine storm.
The results show that COVID-19 is not characterized by a cytokine storm.
The team says the severe disease observed in critically ill COVID-19 patients is therefore not explained by strongly elevated levels of inflammatory proteins in the blood.
This means that critically ill COVID-19 patients likely will not benefit from specific anti-cytokine therapies.
One author of the study is Professor of Intensive Care Medicine Peter Pickkers.
The study is published in JAMA.
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