Profile of Circulatory Cytokines and Chemokines in Human Coronaviruses: A Systematic Review and Meta-Analysis

Abstract

BackgroundSARS, MERS, and COVID-19 share similar characteristics. For instance, the genetic homology of SARS-CoV-2 compared to SARS-CoV and MERS-CoV is 80% and 50%, respectively, which may cause similar clinical features. Moreover, uncontrolled release of proinflammatory mediators (also called a cytokine storm) by activated immune cells in SARS, MERS, and COVID-19 patients leads to severe phenotype development.AimThis systematic review and meta-analysis aimed to evaluate the inflammatory cytokine profile associated with three strains of severe human coronavirus diseases (MERS-CoV, SARS-CoV, and SARS-CoV-2).MethodThe PubMed, Embase, and Cochrane Library databases were searched for studies published until July 2020. Randomized and observational studies reporting the inflammatory cytokines associated with severe and non-severe human coronavirus diseases, including MERS-CoV, SARS-CoV, and SARS-CoV-2, were included. Two reviewers independently screened articles, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using a random-effects model with a 95% confidence interval to estimate the pooled mean of inflammatory biomarkers.ResultsA high level of circulating IL-6 could be associated with the severity of infection of the three coronavirus strains. TNF, IL-10, and IL-8 are associated with the severity of COVID-19. Increased circulating levels of CXCL10/IP10 and CCL2/MCP-1 might also be related to the severity of MERS.ConclusionThis study suggests that the immune response and immunopathology in the three severe human coronavirus strains are somewhat similar. The findings highlight that nearly all studies reporting severe cases of SARS, MERS, and COVID-19 have been associated with elevated levels of IL-6. This could be used as a potential therapeutic target to improve patients’ outcomes in severe cases.Systematic Review RegistrationPROSPERO registration 94 number: CRD42020209931.

Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1

“…Although not statistically significant, we observed that the IL6 level on the 14th day was below that of the cases that did not take vitamin D supplements. A systematic review and meta-analysis study reported that elevated IL6 levels are associated with COVID-19 severity [48]. In the study of Li et al, COVID-19 patients had higher IL6 mRNA expression levels compared with healthy individuals [47].…”

Interleukin-18 Is a Potential Biomarker to Discriminate Active Adult-Onset Still’s Disease From COVID-19

“…Besides, impaired Type-I IFN responses to SARS-CoV-2 in the initial stage may lead to a cytokine storm (7). Several previous studies, including a systemic review and meta-analysis, revealed that the occurrence of cytokine storm is associated with COVID-19 severity and mortality (3,4,(7)(8)(9)(10). Therefore, early identification and optimal treatment of cytokine storms are pivotal in improving disease outcomes (9,10).…”

Community Knowledge of and Attitudes towards COVID-19 Prevention Techniques in Saudi Arabia: A Cross-Sectional Study

“…Surgical masks and N95 respirators are recommended for healthcare workers [ 12 ]. While previous studies in Saudi Arabia have focused on the clinical and mental consequences of COVID-19 [ 13 , 14 , 15 , 16 , 17 ], very few studies have explored community knowledge and attitudes towards the disease, and most of them are restricted to a specific governorate or area. Therefore, this study aimed to assess the community knowledge of and to obtain a broad overview of attitudes towards the appropriate prevention techniques that are recommended by the Ministry of Health (MOH) to prevent COVID-19 transmission in Saudi Arabia before the emergence of COVID-19 drift variants.…”