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New Study Finds COVID-19 Cytokine Storm Does Not Exist, Suggesting Anti-Cytokine Therapies Unlikely to Help

By HospiMedica International staff writers
Posted on 14 Sep 2020
Following the measurement of several important cytokines in patients with COVID-19 and various other severe diseases, researchers have shown that COVID-19 is not characterized by a cytokine storm, which may have consequences for the treatment of these patients.

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. However, 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.

Image: Cytokine storm, crucial cytokines involved in inflammation processes (Photo courtesy of iStock)
Image: Cytokine storm, crucial cytokines involved in inflammation processes (Photo courtesy of iStock)

In order to verify this, researchers at the Intensive Care (IC) department at Radboud University Medical Center (Nijmegen, Netherlands) measured the concentration of three essential cytokines in the blood of patients admitted to intensive care 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. The team measured the concentration of tumor necrosis factor alpha (TNF-alpha) and interleukins 6 and 8 (IL-6, IL-8) in five patient groups and found remarkable results indicating that COVID-19 is not characterized by a cytokine storm.

“The level of cytokines was significantly less elevated in COVID-19 patients than in patients with septic shock and ARDS,” said researcher Matthijs Kox. “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.”

“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,” said Professor of Intensive Care Medicine Peter Pickkers.

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Radboud University Medical Center

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