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Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients

In contrast to dexamethasone, the clinical efficacy of methylprednisolone (MP) remains controversial, and a systems biology study on its mechanism is lacking. In this study, a total of 38 severe COVID-19 patients were included. The demographics, clinical characteristics, and severity biomarkers incl...

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Autores principales: Fan, Qinghong, Deng, Kai, Huang, Huang, He, Ruiying, Deng, Xizi, Lan, Yun, Tan, Yizhou, Chen, Weilie, Wang, Yaping, Deng, Xilong, Hu, Fengyu, Li, Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957869/
https://www.ncbi.nlm.nih.gov/pubmed/35350784
http://dx.doi.org/10.3389/fimmu.2022.758946
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author Fan, Qinghong
Deng, Kai
Huang, Huang
He, Ruiying
Deng, Xizi
Lan, Yun
Tan, Yizhou
Chen, Weilie
Wang, Yaping
Deng, Xilong
Hu, Fengyu
Li, Feng
author_facet Fan, Qinghong
Deng, Kai
Huang, Huang
He, Ruiying
Deng, Xizi
Lan, Yun
Tan, Yizhou
Chen, Weilie
Wang, Yaping
Deng, Xilong
Hu, Fengyu
Li, Feng
author_sort Fan, Qinghong
collection PubMed
description In contrast to dexamethasone, the clinical efficacy of methylprednisolone (MP) remains controversial, and a systems biology study on its mechanism is lacking. In this study, a total of 38 severe COVID-19 patients were included. The demographics, clinical characteristics, and severity biomarkers including C-reactive protein (CRP), d-dimer, albumin, and Krebs von den Lungen 6 of patients receiving MP (n=26, 40 mg or 80 mg daily for 3-5 days) and supportive therapy (n=12) were compared. Longitudinal measurements of 92 cytokines in MP group from admission to over six months after discharge were performed by multiplex Proximity Extension Assay. The results showed that demographics, baseline clinical characteristics were similar in MP and non-MP groups. No death occurred and the hospital stays between the two groups were similar. Kinetics studies showed that MP was not better than supportive therapy at improving the four severity biomarkers. Cytokines in MP group were characterized by five clusters according to their baseline levels and responses to MP. The immunological feature of severe COVID-19 could be defined by the “core signature” cytokines in cluster 2: MCP-3, IL-6, IFN-γ, and CXCL10, which strongly correlated with each other and CRP, and are involved in cytokine release storm. The “core signature” cytokines were significantly upregulated at baseline and remained markedly elevated after MP treatment. Our work showed a short course of MP therapy could not rapidly improve the immune disorders among severe COVID-19 patients or clinical outcomes, also confirmed “core signature” cytokines, as severity biomarkers similar to CRP, could be applied to evaluate clinical treatment effect.
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spelling pubmed-89578692022-03-28 Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients Fan, Qinghong Deng, Kai Huang, Huang He, Ruiying Deng, Xizi Lan, Yun Tan, Yizhou Chen, Weilie Wang, Yaping Deng, Xilong Hu, Fengyu Li, Feng Front Immunol Immunology In contrast to dexamethasone, the clinical efficacy of methylprednisolone (MP) remains controversial, and a systems biology study on its mechanism is lacking. In this study, a total of 38 severe COVID-19 patients were included. The demographics, clinical characteristics, and severity biomarkers including C-reactive protein (CRP), d-dimer, albumin, and Krebs von den Lungen 6 of patients receiving MP (n=26, 40 mg or 80 mg daily for 3-5 days) and supportive therapy (n=12) were compared. Longitudinal measurements of 92 cytokines in MP group from admission to over six months after discharge were performed by multiplex Proximity Extension Assay. The results showed that demographics, baseline clinical characteristics were similar in MP and non-MP groups. No death occurred and the hospital stays between the two groups were similar. Kinetics studies showed that MP was not better than supportive therapy at improving the four severity biomarkers. Cytokines in MP group were characterized by five clusters according to their baseline levels and responses to MP. The immunological feature of severe COVID-19 could be defined by the “core signature” cytokines in cluster 2: MCP-3, IL-6, IFN-γ, and CXCL10, which strongly correlated with each other and CRP, and are involved in cytokine release storm. The “core signature” cytokines were significantly upregulated at baseline and remained markedly elevated after MP treatment. Our work showed a short course of MP therapy could not rapidly improve the immune disorders among severe COVID-19 patients or clinical outcomes, also confirmed “core signature” cytokines, as severity biomarkers similar to CRP, could be applied to evaluate clinical treatment effect. Frontiers Media S.A. 2022-03-08 /pmc/articles/PMC8957869/ /pubmed/35350784 http://dx.doi.org/10.3389/fimmu.2022.758946 Text en Copyright © 2022 Fan, Deng, Huang, He, Deng, Lan, Tan, Chen, Wang, Deng, Hu and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Fan, Qinghong
Deng, Kai
Huang, Huang
He, Ruiying
Deng, Xizi
Lan, Yun
Tan, Yizhou
Chen, Weilie
Wang, Yaping
Deng, Xilong
Hu, Fengyu
Li, Feng
Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients
title Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients
title_full Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients
title_fullStr Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients
title_full_unstemmed Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients
title_short Kinetics of Severity Biomarkers and Immunological Features of Methylprednisolone Therapy for Severe COVID-19 Patients
title_sort kinetics of severity biomarkers and immunological features of methylprednisolone therapy for severe covid-19 patients
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957869/
https://www.ncbi.nlm.nih.gov/pubmed/35350784
http://dx.doi.org/10.3389/fimmu.2022.758946
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