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Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients

Intensive care unit (ICU) admissions and mortality in severe COVID-19 patients are driven by “cytokine storms” and acute respiratory distress syndrome (ARDS). Interim clinical trial results suggest that the corticosteroid dexamethasone displays better 28-day survival in severe COVID-19 patients requ...

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Autores principales: Awasthi, Samir, Wagner, Tyler, Venkatakrishnan, A. J., Puranik, Arjun, Hurchik, Matthew, Agarwal, Vineet, Conrad, Ian, Kirkup, Christian, Arunachalam, Raman, O’Horo, John, Kremers, Walter, Kashyap, Rahul, Morice, William, Halamka, John, Williams, Amy W., Faubion, William A., Badley, Andrew D., Gores, Gregory J., Soundararajan, Venky
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958587/
https://www.ncbi.nlm.nih.gov/pubmed/33723251
http://dx.doi.org/10.1038/s41420-021-00429-9
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author Awasthi, Samir
Wagner, Tyler
Venkatakrishnan, A. J.
Puranik, Arjun
Hurchik, Matthew
Agarwal, Vineet
Conrad, Ian
Kirkup, Christian
Arunachalam, Raman
O’Horo, John
Kremers, Walter
Kashyap, Rahul
Morice, William
Halamka, John
Williams, Amy W.
Faubion, William A.
Badley, Andrew D.
Gores, Gregory J.
Soundararajan, Venky
author_facet Awasthi, Samir
Wagner, Tyler
Venkatakrishnan, A. J.
Puranik, Arjun
Hurchik, Matthew
Agarwal, Vineet
Conrad, Ian
Kirkup, Christian
Arunachalam, Raman
O’Horo, John
Kremers, Walter
Kashyap, Rahul
Morice, William
Halamka, John
Williams, Amy W.
Faubion, William A.
Badley, Andrew D.
Gores, Gregory J.
Soundararajan, Venky
author_sort Awasthi, Samir
collection PubMed
description Intensive care unit (ICU) admissions and mortality in severe COVID-19 patients are driven by “cytokine storms” and acute respiratory distress syndrome (ARDS). Interim clinical trial results suggest that the corticosteroid dexamethasone displays better 28-day survival in severe COVID-19 patients requiring ventilation or oxygen. In this study, 10 out of 16 patients (62.5%) that had an average plasma IL-6 value over 10 pg/mL post administration of corticosteroids also had worse outcomes (i.e., ICU stay >15 days or death), compared to 8 out of 41 patients (19.5%) who did not receive corticosteroids (p-value = 0.0024). Given this potential association between post-corticosteroid IL-6 levels and COVID-19 severity, we hypothesized that the glucocorticoid receptor (GR or NR3C1) may be coupled to IL-6 expression in specific cell types that govern cytokine release syndrome (CRS). Examining single-cell RNA-seq data from BALF of severe COVID-19 patients and nearly 2 million cells from a pan-tissue scan shows that alveolar macrophages, smooth muscle cells, and endothelial cells co-express NR3C1 and IL-6, motivating future studies on the links between the regulation of NR3C1 function and IL-6 levels.
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spelling pubmed-79585872021-03-15 Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients Awasthi, Samir Wagner, Tyler Venkatakrishnan, A. J. Puranik, Arjun Hurchik, Matthew Agarwal, Vineet Conrad, Ian Kirkup, Christian Arunachalam, Raman O’Horo, John Kremers, Walter Kashyap, Rahul Morice, William Halamka, John Williams, Amy W. Faubion, William A. Badley, Andrew D. Gores, Gregory J. Soundararajan, Venky Cell Death Discov Article Intensive care unit (ICU) admissions and mortality in severe COVID-19 patients are driven by “cytokine storms” and acute respiratory distress syndrome (ARDS). Interim clinical trial results suggest that the corticosteroid dexamethasone displays better 28-day survival in severe COVID-19 patients requiring ventilation or oxygen. In this study, 10 out of 16 patients (62.5%) that had an average plasma IL-6 value over 10 pg/mL post administration of corticosteroids also had worse outcomes (i.e., ICU stay >15 days or death), compared to 8 out of 41 patients (19.5%) who did not receive corticosteroids (p-value = 0.0024). Given this potential association between post-corticosteroid IL-6 levels and COVID-19 severity, we hypothesized that the glucocorticoid receptor (GR or NR3C1) may be coupled to IL-6 expression in specific cell types that govern cytokine release syndrome (CRS). Examining single-cell RNA-seq data from BALF of severe COVID-19 patients and nearly 2 million cells from a pan-tissue scan shows that alveolar macrophages, smooth muscle cells, and endothelial cells co-express NR3C1 and IL-6, motivating future studies on the links between the regulation of NR3C1 function and IL-6 levels. Nature Publishing Group UK 2021-03-15 /pmc/articles/PMC7958587/ /pubmed/33723251 http://dx.doi.org/10.1038/s41420-021-00429-9 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Awasthi, Samir
Wagner, Tyler
Venkatakrishnan, A. J.
Puranik, Arjun
Hurchik, Matthew
Agarwal, Vineet
Conrad, Ian
Kirkup, Christian
Arunachalam, Raman
O’Horo, John
Kremers, Walter
Kashyap, Rahul
Morice, William
Halamka, John
Williams, Amy W.
Faubion, William A.
Badley, Andrew D.
Gores, Gregory J.
Soundararajan, Venky
Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients
title Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients
title_full Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients
title_fullStr Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients
title_full_unstemmed Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients
title_short Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients
title_sort plasma il-6 levels following corticosteroid therapy as an indicator of icu length of stay in critically ill covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958587/
https://www.ncbi.nlm.nih.gov/pubmed/33723251
http://dx.doi.org/10.1038/s41420-021-00429-9
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