Repository of Research and Investigative Information

Repository of Research and Investigative Information

Dezful University of Medical Sciences

Increased Serum Levels of Soluble TNF-α Receptor Is Associated With ICU Mortality in COVID-19 Patients

(2021) Increased Serum Levels of Soluble TNF-α Receptor Is Associated With ICU Mortality in COVID-19 Patients. Frontiers in Immunology. ISSN 16643224 (ISSN)

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has infected over 112M patients and resulted in almost 2.5M deaths worldwide. The major clinical feature of severe COVID-19 patients requiring ventilation is acute respiratory distress syndrome (ARDS) possibly associated with a cytokine storm. Objectives: To elucidate serum levels of TNF-α and soluble TNF-Receptor 1 (sTNFR1) in patients with severe and mild COVID-19 disease as determinants of disease severity. Methods: We determined serum TNF-α and sTNFR1 concentrations in 46 patients with laboratory-confirmed COVID-19 (17 patients with severe disease within the intensive care unit ICU and 29 non-severe, non-ICU patients) and 15 healthy controls upon admission using ELISA. Subjects were recruited between March-May 2020 at the Masih Daneshvari Hospital Tehran, Iran. Results: Serum levels of sTNFRI were significantly higher in ICU patients (P<0.0001) and non-ICU patients (P=0.0342) compared with healthy subjects. Serum sTNFR1 were significantly higher in ICU patients than in non-ICU patients (P<0.0001). Serum TNF-α levels were greater in ICU and non-ICU patients than in the healthy subjects group (p<0.0001). The sTNFRI concentration in ICU (r=0.79, p=0.0002) and non-ICU (r=0.42, p=0.02) patients positively correlated with age although serum sTNFRI levels in ICU patients were significantly higher than in older healthy subjects. The sTNFRI concentration in ICU patients negatively correlated with ESR. Conclusions: The study demonstrates higher sTNFRI in ICU patients with severe COVID-19 disease and this be a biomarker of disease severity and mortality. Future studies should examine whether lower levels of systemic sTNFR1 at admission may indicate a better disease outcome. © Copyright © 2021 Mortaz, Tabarsi, Jamaati, Dalil Roofchayee, Dezfuli, Hashemian, Moniri, Marjani, Malekmohammad, Mansouri, Varahram, Folkerts and Adcock.

Item Type: Article
Keywords: ARDS COVID-19 cytokine storm soluble TNF-α TNF-α C reactive protein corticosteroid creatine kinase interleukin 6 lactate dehydrogenase troponin tumor necrosis factor tumor necrosis factor alpha receptor biological marker IL6 protein, human TNF protein, human tumor necrosis factor receptor 1 adult adult respiratory distress syndrome aged Article artificial ventilation biochemical analysis blood oxygen tension cardiovascular disease chronic kidney failure chronic obstructive lung disease clinical article computer assisted tomography coronavirus disease 2019 cytokine release syndrome diabetes mellitus enzyme linked immunosorbent assay erythrocyte sedimentation rate female Horowitz index human hypertension hypotension intensive care unit kidney function test liver function test male middle aged mortality oxygen saturation protein blood level real time polymerase chain reaction blood intensive care Iran pathology pilot study severity of illness index very elderly Aged, 80 and over Biomarkers Critical Care Humans Intensive Care Units Interleukin-6 Pilot Projects Receptors, Tumor Necrosis Factor, Type I SARS-CoV-2 Tumor Necrosis Factor-alpha
Journal or Publication Title: Frontiers in Immunology
Journal Index: Scopus
Volume: 12
Identification Number:
ISSN: 16643224 (ISSN)
Depositing User: مهندس مهدی شریفی

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