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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Crit+Care+Explor 2020 ; 2 (9): e0203 Nephropedia Template TP
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The Association of Inflammatory Cytokines in the Pulmonary Pathophysiology of Respiratory Failure in Critically Ill Patients With Coronavirus Disease 2019 #MMPMID33063041
Stukas S; Hoiland RL; Cooper J; Thiara S; Griesdale DE; Thomas AD; Orde MM; English JC; Chen LYC; Foster D; Mitra AR; Romano K; Sweet DD; Ronco JJ; Kanji HD; Chen YR; Wong SL; Wellington CL; Sekhon MS
Crit Care Explor 2020[Sep]; 2 (9): e0203 PMID33063041show ga
OBJECTIVES: The majority of coronavirus disease 2019 mortality and morbidity is attributable to respiratory failure from severe acute respiratory syndrome coronavirus 2 infection. The pathogenesis underpinning coronavirus disease 2019-induced respiratory failure may be attributable to a dysregulated host immune response. Our objective was to investigate the pathophysiological relationship between proinflammatory cytokines and respiratory failure in severe coronavirus disease 2019. DESIGN: Multicenter prospective observational study. SETTING: ICU. PATIENTS: Critically ill patients with coronavirus disease 2019 and noncoronavirus disease 2019 critically ill patients with respiratory failure (ICU control group). INTERVENTIONS: Daily measurement of serum inflammatory cytokines. MEASUREMENTS AND MAIN RESULTS: Demographics, comorbidities, clinical, physiologic, and laboratory data were collected daily. Daily serum samples were drawn for measurements of interleukin-1beta, interleukin-6, interleukin-10, and tumor necrosis factor-alpha. Pulmonary outcomes were the ratio of Pao(2)/Fio(2) and static lung compliance. Twenty-six patients with coronavirus disease 2019 and 22 ICU controls were enrolled. Of the patients with coronavirus disease 2019, 58% developed acute respiratory distress syndrome, 62% required mechanical ventilation, 12% underwent extracorporeal membrane oxygenation, and 23% died. A negative correlation between interleukin-6 and Pao(2)/Fio(2) (rho, -0.531; p = 0.0052) and static lung compliance (rho, -0.579; p = 0.033) was found selectively in the coronavirus disease 2019 group. Diagnosis of acute respiratory distress syndrome was associated with significantly elevated serum interleukin-6 and interleukin-1beta on the day of diagnosis. CONCLUSIONS: The inverse relationship between serum interleukin-6 and Pao(2)/Fio(2) and static lung compliance is specific to severe acute respiratory syndrome coronavirus 2 infection in critically ill patients with respiratory failure. Similar observations were not found with interleukin-beta or tumor necrosis factor-alpha.