Does the COVID-19 cytokine storm exist?
Research may have an impact on the chances of success of a specific
treatment

Date:
September 4, 2020
Source:
Radboud University Medical Center
Summary:
Cytokines play a crucial role in the immune response. If this
immune response is too strong, also known as 'cytokine storm',
it can cause harm to the patient. Following the measurement
of several important cytokines in patients with COVID-19 and
various other severe diseases, researchers show that COVID-19 is
not characterized by a cytokine storm. This may have consequences
for the treatment of these patients, the researchers write.



FULL STORY ========================================================================== 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.

Following the measurement of several important cytokines in patients
with COVID-19 and various other severe diseases, researchers at Radboud university medical center now show that COVID-19 is not characterized
by a cytokine storm.

This may have consequences for the treatment of these patients, the
researchers write in JAMA.


==========================================================================
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 exists concerning
the cytokine storm in these patients.

Various patient groups Researchers from the Intensive Care (IC) department
at Radboud university medical center have now 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 met the criteria for 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.

Cytokine storm? In the abovedescribed five patient groups, the
concentration of tumor necrosis factor alpha (TNF-alpha) and interleukins
6 and 8 (IL-6, IL-8) was measured.

The results were remarkable. Researcher Matthijs Kox: "The level of
cytokines was significantly less elevated in COVID-19 patients than in
patients with septic shock and ARDS. Compared to patients with septic
shock without ARDS, so without 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." Possible consequences The results from this study
show that COVID-19 is not characterized by a cytokine storm. Professor of Intensive Care Medicine Peter Pickkers: "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."

========================================================================== Story Source: Materials provided by
Radboud_University_Medical_Center. Note: Content may be edited for style
and length.


========================================================================== Journal Reference:
1. Matthijs Kox, Nicole J. B. Waalders, Emma J. Kooistra, Jelle
Gerretsen,
Peter Pickkers. Cytokine Levels in Critically Ill Patients
With COVID-19 and Other Conditions. JAMA, 2020; DOI:
10.1001/jama.2020.17052 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/09/200904100551.htm

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