PMID- 37283736
OWN - NLM
STAT- MEDLINE
DCOM- 20230609
LR  - 20230611
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - Serum IL-23, IL-10, and TNF-alpha predict in-hospital mortality in COVID-19 patients.
PG  - 1145840
LID - 10.3389/fimmu.2023.1145840 [doi]
LID - 1145840
AB  - OBJECTIVE: The hyperinflammatory response, caused by severe acute respiratory 
      syndrome-2 (SARS-CoV-2), is the most common cause of death in patients with 
      coronavirus disease 2019 (COVID-19). The etiopathogenesis of this illness is not 
      fully understood. Macrophages appear to play a key part in COVID-19's pathogenic 
      effects. Therefore, this study aims to examine serum inflammatory cytokines 
      associated with the activation state of macrophages in COVID-19 patients and 
      attempt to find accurate predictive markers for disease severity and mortality 
      risk in hospital. METHODS: 180 patients with COVID-19 and 90 healthy controls 
      (HCs) participated in this study. Patients were divided into three different 
      subgroups, mild (n=81), severe (n=60), and critical groups (n=39). Serum samples 
      were collected and IL (Interleukin)-10, IL-23, tumor necrosis factor-alpha 
      (TNF-alpha), interferon-gamma (IFN-gamma), IL-17, monocyte chemoattractant protein-1 
      (MCP-1) and chemokine ligand 3 (CCL3) were determined by ELISA. In parallel, 
      myeloperoxidase (MPO) and C-reactive protein (CRP) were measured using 
      colorimetric and electrochemiluminescence methods, respectively. Data were 
      collected, and their associations with disease progression and mortality were 
      assessed using regression models and receiver operating characteristic (ROC) 
      curves. RESULTS: Compared to HCs, a significant increase in IL-23, IL-10, TNF-alpha, 
      IFN-gamma and MCP-1, were observed in COVID-19 patients. Serum levels of IL-23, 
      IL-10, and TNF-alpha were significantly higher in COVID-19 patients with critical 
      cases compared to mild and severe cases, and correlated positively with CRP 
      level. However, non-significant changes were found in serum MPO and CCL3 among 
      the studied groups. Moreover, significant positive association has been observed 
      among increased IL-10, IL-23 and TNF-alpha in serum of COVID-19 patients. 
      Furthermore, a binary logistic regression model was applied to predict death's 
      independent factors. Results showed that IL-10 alone or in combination with IL23 
      and TNF-alpha are strongly linked with non-survivors in COVID-19 patients. Finally, 
      ROC curve results uncovered that IL-10, IL-23 and TNF-alpha were excellent predictors 
      for prognosing COVID-19. CONCLUSION: The elevations of IL-10, IL-23, and TNF-alpha 
      levels were seen in severe and critical cases of COVID-19 patients and their 
      elevations were linked to the in-hospital mortality of the disease. A prediction 
      model shows that the determination of these cytokines upon admission is important 
      and should be done on COVID-19 patients as a way of evaluating the prognosis of 
      the disease. COVID-19 Patients with high IL-10, IL-23, and TNF-alpha on admission are 
      more likely to experience a severe form of the disease; therefore, those patients 
      should be cautionary monitored and treated.
CI  - Copyright (c) 2023 Smail, Babaei, Amin and Abdulahad.
FAU - Smail, Shukur Wasman
AU  - Smail SW
AD  - Department of Biology, College of Science, Salahaddin University, Erbil, Iraq.
FAU - Babaei, Esmaeil
AU  - Babaei E
AD  - Department of Biology, School of Natural Sciences, University of Tabriz, Tabriz, 
      Iran.
AD  - Department of Pharmacognosy, College of Pharmacy, Hawler Medical University, 
      Erbil, Iraq.
FAU - Amin, Kawa
AU  - Amin K
AD  - College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
AD  - Department of Medical Science, Respiratory, Allergy and Sleep Research, Uppsala 
      University, Uppsala, Sweden.
FAU - Abdulahad, Wayel H
AU  - Abdulahad WH
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Groningen, University of Groningen, Groningen, Netherlands.
AD  - Department of Pathology and Medical Biology, University Medical Center Groningen, 
      University of Groningen, Groningen, Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20230522
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 130068-27-8 (Interleukin-10)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 0 (Cytokines)
RN  - 82115-62-6 (Interferon-gamma)
RN  - 0 (Interleukin-23)
SB  - IM
MH  - Humans
MH  - *COVID-19
MH  - Interleukin-10
MH  - Tumor Necrosis Factor-alpha
MH  - Hospital Mortality
MH  - SARS-CoV-2
MH  - Cytokines
MH  - Interferon-gamma
MH  - Interleukin-23
PMC - PMC10239952
OTO - NOTNLM
OT  - COVID-19
OT  - SARS-CoV-2
OT  - interleukins
OT  - mortality
OT  - predictors
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/06/07 13:10
MHDA- 2023/06/09 06:41
PMCR- 2023/05/22
CRDT- 2023/06/07 09:37
PHST- 2023/01/16 00:00 [received]
PHST- 2023/05/05 00:00 [accepted]
PHST- 2023/06/09 06:41 [medline]
PHST- 2023/06/07 13:10 [pubmed]
PHST- 2023/06/07 09:37 [entrez]
PHST- 2023/05/22 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1145840 [doi]
PST - epublish
SO  - Front Immunol. 2023 May 22;14:1145840. doi: 10.3389/fimmu.2023.1145840. 
      eCollection 2023.