Studying The Role Of Cytokines In Patients With Covid-19 As A Predictor Of Disease Severity

Abstract

The aim of the study was to examine cytokine production, examining cytokines as predictors of disease severity in patients with COVID-19.

Study materials and methods. Sixty patients with COVID-19 (30 with moderate and 30 with severe disease) hospitalized at the Zangiota 1 Specialized Hospital for the Treatment of Patients with Coronavirus Infection and 25 apparently healthy individuals were examined. The COVID-19 diagnosis was based on current protocols of the Ministry of Health of the Republic of Uzbekistan. All patients tested positive for SARS-CoV-2 using real-time PCR on a throat swab. Immunological studies were performed using the ELISA method (IL-1β, IL-6, IFN-gamma).

Results and discussion. Measurement of total cytokine levels of IL-1 beta, IL-6, and IFN-gamma revealed a moderate and statistically significant increase in three cytokines (p<0.0001) in severe patients, indicating active inflammation. IFN-γ levels showed a slight increase in the severe group compared to the moderate group. Thus, total IL-1 beta and IL-6 levels showed significant heterogeneity. Early studies of COVID-19 indicated the role of proinflammatory cytokines such as IL-1 beta, IL-6, and IFN-gamma released by activated mast cells in the respiratory submucosa in exacerbating inflammation and pathogenesis. Despite the uncertainty of the therapeutic potential of IL-6 and IL-10, the observed levels of their elevation in patients with severe COVID-19 have prompted clinical researchers to explore their use as prognostic factors.

Conclusions. 1. A significant increase in the cytokines IL-1 beta, IL-6, and IFN-gamma was demonstrated in both groups of patients, with a significant increase in these cytokines observed in the group of severely ill patients.

1. It was shown that the proposed simple panel of three cytokines can be used as predictors for the rapid diagnosis of patients at higher risk of worsening the course of COVID-19 disease.
2. IFN-γ levels showed a slight increase in the severe group compared to the moderate group. IL-1 beta and IFN-gamma levels were shown to be age-dependent, while the age-dependent relationship for IL-6 was not significant. No gender-dependent relationship was found for IL-6 levels.
3. These studies will be key to identifying patients who are more likely to progress to severe disease and thus taking the necessary precautions.