Objective: The increased level of interleukin (IL)-33 is considered as a predictor of severe coronavirus disease 2019 (COVID-19) infection, but its role at different stages of the disease is still unclear. Our goal was to analyze the correlation of IL-33 and other innate immunity cytokines with disease severity. Methods: In this study, 220 patients with COVID-19 were included and divided into two groups, mild/moderate and severe/critical. The value of the cytokines, clinical, biochemical, radiographic data was collected and their correlation with disease severity was analyzed. Results: Most patients in the severe/critical group were male (81.8%) and older (over 64.5 years). We found a statistically significant difference ( p < 0.05) in these two groups between clinical features (dyspnea, dry cough, fatigue, and auscultatory findings); laboratory [(neutrophil count, lymphocyte count, monocyte count, hemoglobin, plasma glucose, urea, creatinine, total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), albumin (ALB), lactate dehydrogenase (LDH), creatinine kinase (CK), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), Fe, and Ferritin)], arterial blood gases (oxygen saturation-Sa0 2 , partial pressure of oxygen -p0 2 ), and chest X-rays (CXR) lung findings ( p = 0 .000). We found a significantly higher serum concentration ( p < 0.05) of TNF-α, IL-1β, IL-6, IL-12, IL-23, and IL-33 in patients with COVID-19 with severe disease. In the milder stage of COVID-19, a positive correlation was detected between IL-33 and IL-1β, IL-12 and IL-23, while a stronger positive correlation between the serum values of IL-33 and TNF-α, IL-1β, IL-6, and IL-12 and IL-23 was detected in patients with COVID-19 with severe disease. A weak negative correlation ( p < 0.05) between pO 2 and serum IL-1β, IL-12, and IL-33 and between SaO 2 and serum IL-33 was noted. The positive relation ( p < 0.05) between the serum values of IL-33 and IL-12, IL-33 and IL-6, and IL-6 and IL-12 is proven. Conclusion: In a more progressive stage of COVID-19, increased IL-33 facilitates lung inflammation by inducing the production of various innate proinflammatory cytokines (IL-1β, IL-6, TNF-α, IL-12, and IL-23) in several target cells leading to the most severe forms of the disease. IL-33 correlates with clinical parameters of COVID-19 and might represent a promising marker as well as a therapeutic target in COVID-19.
【저자키워드】 COVID-19, disease severity, correlation, IL 33, proinflammatory innate immune response, 【초록키워드】 Cytokines, fatigue, Innate immunity, IL-6, Infection, lung, LDH, C-reactive protein, CRP, D-dimer, procalcitonin, oxygen, cytokine, lactate dehydrogenase, Laboratory, monocyte, Lymphocyte count, serum, Dyspnea, male, albumin, IL-33, Aspartate aminotransferase, AST, plasma, chest X-ray, hemoglobin, clinical feature, Glucose, TNF-α, marker, IL-1β, creatinine, Lung inflammation, Concentration, severe disease, Bilirubin, CXR, therapeutic target, urea, target cell, Proinflammatory cytokine, Older, creatinine kinase, two groups, biochemical, total bilirubin, severe coronavirus disease, dry cough, positive correlation, statistically significant difference, Stage, Radiographic, negative correlation, IL-12, positive, clinical parameter, IL-23, PCT, analyzed, the disease, form, Most patient, was collected, facilitate, significantly higher, two group, ALB, arterial blood gase, patients with COVID-19, 【제목키워드】 clinical, finding,