Infectious Disease Reports (Apr 2021)

Absence of “Cytokine Storm” in Hospitalized COVID-19 Patients: A Retrospective Cohort Study

  • Maeghan L. Ciampa,
  • Thomas A. O’Hara,
  • Constance L. Joel,
  • Melinda M. Gleaton,
  • Kirti K. Tiwari,
  • Daniel M. Boudreaux,
  • Balakrishna M. Prasad

DOI
https://doi.org/10.3390/idr13020036
Journal volume & issue
Vol. 13, no. 2
pp. 377 – 387

Abstract

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Background: A rapidly growing number of publications cite “cytokine storm” as a contributing factor in coronavirus disease 2019 (COVID-19) pathology. However, a few recent reports led to questioning of “cytokine storm” theory in COVID-19. This study’s primary goal is to determine if exaggerated cytokine response in the range of a “cytokine storm” develops during the initial weeks of hospitalization in COVID-19 patients. Methods: Five proinflammatory cytokines reported to be involved in “cytokine storm” and elevated in COVID-19 (IL-6, IL-8, TNF-α, MCP-1, and IP-10) were analyzed in COVID-19, influenza (with “cytokine storm”: CS), and burn injury patients. The effect of dexamethasone use on cytokine response in COVID-19 was also analyzed. Results: None of the five cytokines in COVID-19 patients reached the lower threshold (95% CI) of the influenza (CS) group at any point during the study period. Furthermore, mean concentrations of all five cytokines in the influenza (CS) group and IL-6, IL-8, TNF-α in the burn group were significantly greater than in COVID-19 patients (p Conclusions: Exaggerated cytokine response similar to “cytokine storm” was not observed in COVID-19 patients during two weeks of hospitalization.

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