Our study included 142 patients (with SARS-CoV-2 PCR-positive nasopharyngeal samples) with varying disease severity and admitted on different days of the disease. We examined the presence and mean levels of TNF-α and IL-10 and did a correlation and logistic regression analysis.
TNF-α levels were high in all patients, with mean levels being the highest on day 5 of the disease. IL-10 was high only in a quarter of the patients. The levels of IL-10 were also the highest on day 5, which was significantly different from the mean levels on the other days of the disease. Average IL-10 levels were not any higher than the normal range on the other days. We found a significant positive correlation between the levels of TNF-α and IL-10 during the first week of the infection. In the second week, the positive correlation was no longer significant, and starting from day 10, there was even a slight negative correlation. IL-10 level increase showed prognostic significance for severe, but not the critical forms of the disease.
The uncontrolled immune response to SARS-CoV-2 in the second week of the disease can be the result of dysregulated production of endogenous anti-inflammatory cytokines. This leads to a severe disease course and a possible unfavorable outcome.
方法:我们的研究包括142例患者(SARS-CoV-2PCR阳性的鼻咽标本),这些患者在疾病的不同天数入院。我们检查了TNF-α和IL-10的存在和平均水平,并进行了相关性和逻辑回归分析。
结果:所有患者的TNF-α水平都很高,疾病第5天的平均水平最高。IL-10仅在四分之一的患者中很高。IL-10的水平在第5天也最高,与疾病其他日子的平均水平显着不同。其他日子的平均IL-10水平不高于正常范围。我们发现在感染的第一周,TNF-α和IL-10的水平之间存在显着正相关。第二周,正相关不再显著,从第10天开始,甚至有轻微的负相关。IL-10水平升高对严重,但不是这种疾病的关键形式。
结论:在疾病第二周对SARS-CoV-2的免疫反应失控可能是内源性抗炎细胞因子产生失调的结果。这导致严重的疾病过程和可能的不利结果。