COVID-19 is not characterized by a cytokine storm, shows stu
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An abnormally strong proinflammatory response known as “cytokine storm” may play an important role in the pathophysiology of COVID-19. The question remains, however, whether all cytokine storms strike people with different conditions the same way.

Key Points:

• Researchers studied 46 people with COVID-19 and acute respiratory distress syndrome (ARDS) who were admitted to the ICU. All participants underwent mechanical ventilation and were treated.

• The investigators measured plasma levels of cytokines, including tumor necrosis factor (TNF), interleukin-6 (IL-6), and interleukin-8 (IL-8).

• They compared results in this group to those in 51 patients who experienced septic shock and ARDS, 15 patients with septic shock without ARDS, 30 people with out-of-hospital cardiac arrest, and 62 people who experienced multiple traumas.

• Levels of all 3 cytokines were significantly lower in patients with COVID-19 than in patients with septic shock with ARDS.

• Patients with COVID-19 also displayed significantly lower IL-6 and IL-8 concentrations compared with patients with septic shock without ARDS.

• TNF levels in patients with COVID-19 were higher than those in trauma patients, whereas no differences between patients with COVID-19 and OHCA or trauma were present for IL-6.

• For IL-8, lower concentrations were found in patients with COVID-19 compared with patients with OHCA, while no differences vs the trauma group were observed.

• In this study, critically ill patients with COVID-19 with ARDS had circulating cytokine levels that were lower compared with patients with bacterial sepsis and similar to other critically ill patients.

These findings suggest COVID-19 may not be characterized by a cytokine storm. Whether anti-cytokine therapies will benefit patients with COVID-19 remains to be determined.

Source: https://jamanetwork.com/journals/jama/fullarticle/2770484
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