Background The role of type I interferons (IFNs) in the early phase of COVID-19 remains unclear. Objectives To evaluate the relationship between IFN-I levels in patients with COVID-19 and clinical presentation, SARS-CoV-2 viral load, and other major pro-inflammatory cytokines. Methods This prospective observational study recruited patients hospitalized with COVID-19. The levels of interferon-alpha (IFN-α), interferon-beta (IFN-β), interleukin-6 (IL-6), and C-X-C motif chemokine ligand (CXCL10) within 5 days after symptom onset were measured using an ELISA, in serum from blood collected within 5 days after the onset of symptoms. The SARS-CoV-2 viral load was determined via qPCR using nasal-swab specimens and serum. Results The study enrolled 50 patients with COVID-19. IFN-α levels were significantly higher in patients who presented with pneumonia or developed hypoxemic respiratory failure (p < 0.001). Furthermore, IFN-α levels were associated with viral load in nasal-swab specimens and RNAemia (p < 0.05). In contrast, there was no significant association between IFN-β levels and the presence of pneumonia or RNAemia, despite showing a stronger association with nasal-swab viral load (p < 0.001). Correlation analysis showed that the serum levels of IFN-α significantly correlated with those of IFN-β, IL-6, and CXCL10, while the levels of IFN-β did not correlate with those of IL-6 or CXCL10. Conclusions Serum IFN-I levels in the early phase of SARS-CoV-2 infection were higher in patients who developed hypoxemic respiratory failure. The association between IFN-α, IL-6, and CXCL10 may reflect the systemic immune response against SARS-CoV-2 invasion into pulmonary circulation, which might be an early predictor of respiratory failure due to COVID-19.
【저자키워드】 COVID-19, Pneumonia, CXCL10, interleukin-6, type I interferon, Hypoxemia, 【초록키워드】 SARS-CoV-2, interferon-alpha, Respiratory failure, IL-6, prospective observational study, SARS-COV-2 infection, ELISA, chemokine, serum, Viral load, qPCR, Patient, IFN-I, Interferon-beta, circulation, IFNs, Blood, association, Ligand, Analysis, Invasion, IFN-α, systemic immune response, symptom onset, Serum level, IFN-β, early phase, SARS-CoV-2 viral load, specimen, motif, hypoxemic, objective, Result, enrolled, collected, evaluate, significantly, recruited, was determined, correlated, significantly higher, onset of symptoms, were measured, patients hospitalized, patients with COVID-19, with COVID-19, 【제목키워드】 respiratory, development, phase, failure, Type, Level,