Longitudinal clinical and radiographic evaluation reveals interleukin-6 as an indicator of persistent pulmonary injury in COVID-19
: Previous studies of coronavirus disease 2019 (COVID-19) were mainly focused on cross-sectional analysis. In this study, we sought to evaluate the dynamic changes of immunological and radiographic features, and the association with the outcome of pulmonary lesions in COVID-19 patients. : Peripheral...
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| Veröffentlicht in: | International journal of medical sciences 2021, Vol.18 (1), p.29-41 |
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| creator | Liao, Baolin Liu, Zhipeng Tang, Libo Li, Linghua Gan, Qingxin Shi, Haiyan Jiao, Qian Guan, Yujuan Xie, Min He, Xi Zhao, Han Chen, Weilie Liu, Yanxia Li, Liya Wang, Yaping Cao, Yi Shi, Yaling Li, Yongyin Lei, Chunliang |
| description | : Previous studies of coronavirus disease 2019 (COVID-19) were mainly focused on cross-sectional analysis. In this study, we sought to evaluate the dynamic changes of immunological and radiographic features, and the association with the outcome of pulmonary lesions in COVID-19 patients.
: Peripheral blood samples and radiographic data were collected longitudinally for up to 8 weeks from 158 laboratory-confirmed COVID-19 patients. The chest computed tomography (CT) scans were scored based on a semi-quantification assessment according to the extent of pulmonary abnormalities; the temporal change of the immunological and radiographic features was analyzed.
Compared with mild and moderate patients, severe patients had significantly decreased counts of lymphocytes, CD4
T cells, CD8
T cells, and CD19
B cells but dramatically elevated counts of neutrophils and levels of interleukin (IL)-6. Sequential monitoring showed a sustained increase in lymphocytes counts and significantly decreased levels of IL-6 in severe patients during the disease course. Notably, patients with persistent pulmonary lesions (CT score ≥ 5 in week 8) showed high levels of IL-6 during the follow-up period, compared with those with recovery lesions (CT score < 5 in week 8). More importantly, the peak expression of IL-6 prior to the aggravated lung injury was mainly found in patients with persistent lesions, and multivariate analysis showed that IL-6 level upon admission was an independent factor associated with the persistent pulmonary injury.
Prolonged elevation of IL-6 is associated with persistent pulmonary lesions in COVID-19 patients. Sequential monitoring and timely intervention of IL-6 may favor the clinical management of COVID-19. |
| doi_str_mv | 10.7150/ijms.49728 |
| format | Article |
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: Peripheral blood samples and radiographic data were collected longitudinally for up to 8 weeks from 158 laboratory-confirmed COVID-19 patients. The chest computed tomography (CT) scans were scored based on a semi-quantification assessment according to the extent of pulmonary abnormalities; the temporal change of the immunological and radiographic features was analyzed.
Compared with mild and moderate patients, severe patients had significantly decreased counts of lymphocytes, CD4
T cells, CD8
T cells, and CD19
B cells but dramatically elevated counts of neutrophils and levels of interleukin (IL)-6. Sequential monitoring showed a sustained increase in lymphocytes counts and significantly decreased levels of IL-6 in severe patients during the disease course. Notably, patients with persistent pulmonary lesions (CT score ≥ 5 in week 8) showed high levels of IL-6 during the follow-up period, compared with those with recovery lesions (CT score < 5 in week 8). More importantly, the peak expression of IL-6 prior to the aggravated lung injury was mainly found in patients with persistent lesions, and multivariate analysis showed that IL-6 level upon admission was an independent factor associated with the persistent pulmonary injury.
Prolonged elevation of IL-6 is associated with persistent pulmonary lesions in COVID-19 patients. Sequential monitoring and timely intervention of IL-6 may favor the clinical management of COVID-19.</description><identifier>ISSN: 1449-1907</identifier><identifier>EISSN: 1449-1907</identifier><identifier>DOI: 10.7150/ijms.49728</identifier><identifier>PMID: 33390771</identifier><language>eng</language><publisher>Australia: Ivyspring International Publisher Pty Ltd</publisher><subject>Acids ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers - blood ; Coronaviruses ; COVID-19 ; COVID-19 - blood ; COVID-19 - complications ; COVID-19 - diagnostic imaging ; COVID-19 - immunology ; Cytokines ; Female ; Flow cytometry ; Humans ; Immunology ; Infections ; Influenza ; Interleukin-6 - blood ; Longitudinal Studies ; Lung Injury - blood ; Lung Injury - diagnostic imaging ; Lung Injury - virology ; Lymphocyte Count ; Male ; Middle Aged ; Pneumonia ; Radiography, Thoracic ; Research Paper ; Retrospective Studies ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Statistical analysis ; Tomography, X-Ray Computed ; Viral infections ; Young Adult</subject><ispartof>International journal of medical sciences, 2021, Vol.18 (1), p.29-41</ispartof><rights>The author(s).</rights><rights>2021. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The author(s) 2021</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-f0d4eb283cd91af27c97856b5985f18beb4ea1cc11cfe5f7d108d5b99f9defa03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738960/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738960/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,4010,27900,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33390771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liao, Baolin</creatorcontrib><creatorcontrib>Liu, Zhipeng</creatorcontrib><creatorcontrib>Tang, Libo</creatorcontrib><creatorcontrib>Li, Linghua</creatorcontrib><creatorcontrib>Gan, Qingxin</creatorcontrib><creatorcontrib>Shi, Haiyan</creatorcontrib><creatorcontrib>Jiao, Qian</creatorcontrib><creatorcontrib>Guan, Yujuan</creatorcontrib><creatorcontrib>Xie, Min</creatorcontrib><creatorcontrib>He, Xi</creatorcontrib><creatorcontrib>Zhao, Han</creatorcontrib><creatorcontrib>Chen, Weilie</creatorcontrib><creatorcontrib>Liu, Yanxia</creatorcontrib><creatorcontrib>Li, Liya</creatorcontrib><creatorcontrib>Wang, Yaping</creatorcontrib><creatorcontrib>Cao, Yi</creatorcontrib><creatorcontrib>Shi, Yaling</creatorcontrib><creatorcontrib>Li, Yongyin</creatorcontrib><creatorcontrib>Lei, Chunliang</creatorcontrib><title>Longitudinal clinical and radiographic evaluation reveals interleukin-6 as an indicator of persistent pulmonary injury in COVID-19</title><title>International journal of medical sciences</title><addtitle>Int J Med Sci</addtitle><description>: Previous studies of coronavirus disease 2019 (COVID-19) were mainly focused on cross-sectional analysis. In this study, we sought to evaluate the dynamic changes of immunological and radiographic features, and the association with the outcome of pulmonary lesions in COVID-19 patients.
: Peripheral blood samples and radiographic data were collected longitudinally for up to 8 weeks from 158 laboratory-confirmed COVID-19 patients. The chest computed tomography (CT) scans were scored based on a semi-quantification assessment according to the extent of pulmonary abnormalities; the temporal change of the immunological and radiographic features was analyzed.
Compared with mild and moderate patients, severe patients had significantly decreased counts of lymphocytes, CD4
T cells, CD8
T cells, and CD19
B cells but dramatically elevated counts of neutrophils and levels of interleukin (IL)-6. Sequential monitoring showed a sustained increase in lymphocytes counts and significantly decreased levels of IL-6 in severe patients during the disease course. Notably, patients with persistent pulmonary lesions (CT score ≥ 5 in week 8) showed high levels of IL-6 during the follow-up period, compared with those with recovery lesions (CT score < 5 in week 8). More importantly, the peak expression of IL-6 prior to the aggravated lung injury was mainly found in patients with persistent lesions, and multivariate analysis showed that IL-6 level upon admission was an independent factor associated with the persistent pulmonary injury.
Prolonged elevation of IL-6 is associated with persistent pulmonary lesions in COVID-19 patients. Sequential monitoring and timely intervention of IL-6 may favor the clinical management of COVID-19.</description><subject>Acids</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomarkers - blood</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - blood</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - diagnostic imaging</subject><subject>COVID-19 - immunology</subject><subject>Cytokines</subject><subject>Female</subject><subject>Flow cytometry</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infections</subject><subject>Influenza</subject><subject>Interleukin-6 - blood</subject><subject>Longitudinal Studies</subject><subject>Lung Injury - blood</subject><subject>Lung Injury - diagnostic imaging</subject><subject>Lung Injury - virology</subject><subject>Lymphocyte Count</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pneumonia</subject><subject>Radiography, Thoracic</subject><subject>Research Paper</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Statistical analysis</subject><subject>Tomography, X-Ray Computed</subject><subject>Viral infections</subject><subject>Young Adult</subject><issn>1449-1907</issn><issn>1449-1907</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkU9r3DAQxUVpaNK0l36AIuilFJxKlr2yLoWw6Z_AQi5tr0KWRhttZcmVrIVe88mrTdKQ9DTDzG8ej3kIvaHkjNOefHS7KZ91grfDM3RCu040VBD-_FF_jF7mvCOEtYzTF-iYMVannJ6gm00MW7cU44LyWHsXnK6NCgYnZVzcJjVfO41hr3xRi4sBJ9iD8hm7sEDyUH650KywyvWozky9X2LC0eIZUnZ5gbDgufgpBpX-VGJXbgteX_28vKj2XqEjW_Xg9X09RT--fP6-_tZsrr5ers83je7IamksMR2M7cC0EVTZlmvBh3419mLoLR1GGDtQVGtKtYXeckPJYPpRCCsMWEXYKfp0pzuXcQKjq6-kvJyTm6oxGZWTTzfBXctt3EvO2SBWB4H39wIp_i6QFzm5rMF7FSCWLNuO92TghPQVffcfuosl1RdXqhpuB0rJQfDDHaVTzDmBfTBDiTxEKw_RyttoK_z2sf0H9F-W7C9KV6M5</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Liao, Baolin</creator><creator>Liu, Zhipeng</creator><creator>Tang, Libo</creator><creator>Li, Linghua</creator><creator>Gan, Qingxin</creator><creator>Shi, Haiyan</creator><creator>Jiao, Qian</creator><creator>Guan, Yujuan</creator><creator>Xie, Min</creator><creator>He, Xi</creator><creator>Zhao, Han</creator><creator>Chen, Weilie</creator><creator>Liu, Yanxia</creator><creator>Li, Liya</creator><creator>Wang, Yaping</creator><creator>Cao, Yi</creator><creator>Shi, Yaling</creator><creator>Li, Yongyin</creator><creator>Lei, Chunliang</creator><general>Ivyspring International Publisher Pty Ltd</general><general>Ivyspring International Publisher</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2021</creationdate><title>Longitudinal clinical and radiographic evaluation reveals interleukin-6 as an indicator of persistent pulmonary injury in COVID-19</title><author>Liao, Baolin ; Liu, Zhipeng ; Tang, Libo ; Li, Linghua ; Gan, Qingxin ; Shi, Haiyan ; Jiao, Qian ; Guan, Yujuan ; Xie, Min ; He, Xi ; Zhao, Han ; Chen, Weilie ; Liu, Yanxia ; Li, Liya ; Wang, Yaping ; Cao, Yi ; Shi, Yaling ; Li, Yongyin ; Lei, Chunliang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-f0d4eb283cd91af27c97856b5985f18beb4ea1cc11cfe5f7d108d5b99f9defa03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acids</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomarkers - blood</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - blood</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - diagnostic imaging</topic><topic>COVID-19 - immunology</topic><topic>Cytokines</topic><topic>Female</topic><topic>Flow cytometry</topic><topic>Humans</topic><topic>Immunology</topic><topic>Infections</topic><topic>Influenza</topic><topic>Interleukin-6 - blood</topic><topic>Longitudinal Studies</topic><topic>Lung Injury - blood</topic><topic>Lung Injury - diagnostic imaging</topic><topic>Lung Injury - virology</topic><topic>Lymphocyte Count</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pneumonia</topic><topic>Radiography, Thoracic</topic><topic>Research Paper</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Statistical analysis</topic><topic>Tomography, X-Ray Computed</topic><topic>Viral infections</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Liao, Baolin</creatorcontrib><creatorcontrib>Liu, Zhipeng</creatorcontrib><creatorcontrib>Tang, Libo</creatorcontrib><creatorcontrib>Li, Linghua</creatorcontrib><creatorcontrib>Gan, Qingxin</creatorcontrib><creatorcontrib>Shi, Haiyan</creatorcontrib><creatorcontrib>Jiao, Qian</creatorcontrib><creatorcontrib>Guan, Yujuan</creatorcontrib><creatorcontrib>Xie, Min</creatorcontrib><creatorcontrib>He, Xi</creatorcontrib><creatorcontrib>Zhao, Han</creatorcontrib><creatorcontrib>Chen, Weilie</creatorcontrib><creatorcontrib>Liu, Yanxia</creatorcontrib><creatorcontrib>Li, Liya</creatorcontrib><creatorcontrib>Wang, Yaping</creatorcontrib><creatorcontrib>Cao, Yi</creatorcontrib><creatorcontrib>Shi, Yaling</creatorcontrib><creatorcontrib>Li, Yongyin</creatorcontrib><creatorcontrib>Lei, Chunliang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liao, Baolin</au><au>Liu, Zhipeng</au><au>Tang, Libo</au><au>Li, Linghua</au><au>Gan, Qingxin</au><au>Shi, Haiyan</au><au>Jiao, Qian</au><au>Guan, Yujuan</au><au>Xie, Min</au><au>He, Xi</au><au>Zhao, Han</au><au>Chen, Weilie</au><au>Liu, Yanxia</au><au>Li, Liya</au><au>Wang, Yaping</au><au>Cao, Yi</au><au>Shi, Yaling</au><au>Li, Yongyin</au><au>Lei, Chunliang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Longitudinal clinical and radiographic evaluation reveals interleukin-6 as an indicator of persistent pulmonary injury in COVID-19</atitle><jtitle>International journal of medical sciences</jtitle><addtitle>Int J Med Sci</addtitle><date>2021</date><risdate>2021</risdate><volume>18</volume><issue>1</issue><spage>29</spage><epage>41</epage><pages>29-41</pages><issn>1449-1907</issn><eissn>1449-1907</eissn><abstract>: Previous studies of coronavirus disease 2019 (COVID-19) were mainly focused on cross-sectional analysis. In this study, we sought to evaluate the dynamic changes of immunological and radiographic features, and the association with the outcome of pulmonary lesions in COVID-19 patients.
: Peripheral blood samples and radiographic data were collected longitudinally for up to 8 weeks from 158 laboratory-confirmed COVID-19 patients. The chest computed tomography (CT) scans were scored based on a semi-quantification assessment according to the extent of pulmonary abnormalities; the temporal change of the immunological and radiographic features was analyzed.
Compared with mild and moderate patients, severe patients had significantly decreased counts of lymphocytes, CD4
T cells, CD8
T cells, and CD19
B cells but dramatically elevated counts of neutrophils and levels of interleukin (IL)-6. Sequential monitoring showed a sustained increase in lymphocytes counts and significantly decreased levels of IL-6 in severe patients during the disease course. Notably, patients with persistent pulmonary lesions (CT score ≥ 5 in week 8) showed high levels of IL-6 during the follow-up period, compared with those with recovery lesions (CT score < 5 in week 8). More importantly, the peak expression of IL-6 prior to the aggravated lung injury was mainly found in patients with persistent lesions, and multivariate analysis showed that IL-6 level upon admission was an independent factor associated with the persistent pulmonary injury.
Prolonged elevation of IL-6 is associated with persistent pulmonary lesions in COVID-19 patients. Sequential monitoring and timely intervention of IL-6 may favor the clinical management of COVID-19.</abstract><cop>Australia</cop><pub>Ivyspring International Publisher Pty Ltd</pub><pmid>33390771</pmid><doi>10.7150/ijms.49728</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acids Adolescent Adult Aged Aged, 80 and over Biomarkers - blood Coronaviruses COVID-19 COVID-19 - blood COVID-19 - complications COVID-19 - diagnostic imaging COVID-19 - immunology Cytokines Female Flow cytometry Humans Immunology Infections Influenza Interleukin-6 - blood Longitudinal Studies Lung Injury - blood Lung Injury - diagnostic imaging Lung Injury - virology Lymphocyte Count Male Middle Aged Pneumonia Radiography, Thoracic Research Paper Retrospective Studies SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Statistical analysis Tomography, X-Ray Computed Viral infections Young Adult |
| title | Longitudinal clinical and radiographic evaluation reveals interleukin-6 as an indicator of persistent pulmonary injury in COVID-19 |
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