IL-6 and IL-10 are associated with disease severity and higher comorbidity in adults with COVID-19

Abstract

Aim COVID-19 pandemic has caused extensive burden on public life and health care worldwide. This study aimed to assess circulating levels of inflammatory cytokines in adult patients who were hospitalized with COVID-19 and stratified according to age (older or younger than 65 years) aiming to explore associations between these markers of inflammation and comorbidities. Methods This was a retrospective cohort study of 142 COVID-19 patients consecutively admitted to the University Hospital of the Federal University of São Carlos, from July to October 2020. Sociodemographic data, chronic comorbidities, and baseline NEWS2 and SOFA for clinical deterioration were obtained at hospital admission. Serum levels of inflammatory cytokines were determined by flow cytometry. Results Older adults with COVID-19 had higher serum levels of IL-6 and IL-10 as compared to those under 65 years of age (p < 0.001 and p = 0.003, respectively). IL-10 was independently associated with age (p = 0.04) and severity of the disease (p = 0.05), whereas serum levels of IL-6 were not directly associated with age (p = 0.5). The comorbidity index seems to be the main responsible for this, being significantly associated with IL-6 levels among those aged 65 and over (p = 0.007), in addition to the severity of the disease. Conclusions Higher serum levels of IL-6 and IL-10 are associated with the severity of the disease and a higher comorbidity index among adults aged 65 and over with COVID-19. This should raise awareness of the importance of comorbidity index, rather than age, during risk stratification.

Preliminary Evidence for IL-10-Induced ACE2 mRNA Expression in Lung-Derived and Endothelial Cells: Implications for SARS-Cov-2 ARDS Pathogenesis

“…An early induction of anti-inflammatory mediator IL-10 upon SARS-CoV-2 infection might function as a mediator that serves as a countermeasure to inflammation and coagulopathy ( 40 ); given the dual IL-10 (32, 35) caution is mandatory. The initial evidence is limited, and further studies are warranted to confirm the role IL-10 in COVID-19.…”

“…Patients with severe and fatal disease had significantly increased IL-6 and IL-10. These were strong discriminators in Chinese cohorts ( 39 ) and Brazilian cohorts ( 40 ). The levels of IL-10 are positively correlated with CRP amount ( 38 ).…”

Elevations in Liver Transaminases in COVID-19: (How) Are They Related?

“…It has been demonstrated that a progressive drop in lymphocyte count leads to the progressive elevation of IL-10 levels, which serves as a regulator of inflammatory cytokines and an enhancer of B cell proliferation (36)(37)(38). Accordingly, studies have linked higher levels of IL-10 in patients with COVID-19 to increased production of other systemic inflammatory cytokines, which can contribute to the severity of the disease (36,39). Thus, IL-10 appears to be a key cytokine in the inflammatory process related to COVID-19 and to correlate IL-10 levels with other inflammatory parameters may contribute to the understanding of how this cytokine storm can lead to damage in other organs, like the liver.…”

A distinct association of inflammatory molecules with outcomes of COVID-19 in younger versus older adults

“…Our results are in line with a recent meta-analysis showing IL-10 as a covariate predicting disease severity [ 24 ]. A study reported an association of circulating IL-10 levels with age in 142 adult patients with COVID-19 after adjusting for comorbidity and disease severity [ 25 ]. The exact biological significance of such a relationship in COVID-19 is yet to be elucidated although several possibilities exist.…”