Letter to the Editor in response to Chen et al. 2020
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LETTER TO THE EDITOR
Letter to the Editor in response to Chen et al. 2020 Jaya Ponnampalam* , George Seligmann, Tanaya Gandhi and Dilen Parmar
Abstract We would like to comment on the article entitled “Association between cytokine profiles and lung injury in COVID-19 pneumonia” by Li-Da Chen and colleagues, with respect to emerging data regarding the immunopathogenesis of COVID-19. Chen et al. demonstrated the relevance of IL-2R, IL-6 and TNF-α in the cytokine storm and IL-6 as an independent predictor for COVID-19 severity. Del Valle et al. corroborated these findings with regard to IL-6 and disease severity, however, they also showed IL-8 to be of significance. This may be explained by the varying techniques used by the two studies to determine severity. Further studies including critically ill patients and the analysis of mortality rates in this patient cohort would greatly enhance the clinical relevance of these findings. As speculated by Chen et al., early studies on the use of tocilizumab in COVID-19 patients were promising, however, full results from ongoing trials are required to confirm a survival benefit in patients treated with tocilizumab. Moreover, investigating the roles of other pro-inflammatory cytokines and their impact on disease severity could potentially inform novel therapeutic targets. Keywords: Coronavirus disease 2019, Cytokines, Interleukin-6, Tocilizumab Dear Editor, We read with great interest the article entitled: “Association between cytokine profiles and lung injury in COVID-19 pneumonia” by Chen et al. [1]. The authors established that three key cytokines (interleukin (IL)2R, IL-6, tumour necrosis factor (TNF)-α) were significantly higher in 94 coronavirus disease 2019 (COVID-19) patients with pneumonia in comparison to 12 COVID-19 patients without pneumonia (p = 0.002, p = 0.016 and p = 0.016 respectively). To determine the impact of these cytokines, the authors assessed lung injury through computed tomography (CT) severity score and the ratio of PaO2/FiO2. The results showed that IL-2R and IL-6 were significantly correlated with these markers of disease This comment refers to the article available online at https://doi.org/10.1186/ s12931-020-01465-2. *Correspondence: [email protected] University College London Medical School, 74 Huntley S, London WC1E 6DE, UK
severity. However, a statistically significant association was not found between TNF-α and COVID-19 severity. A study by Del Valle et al. [2] investigated the impact of pro-inflammatory cytokines on COVID-19 severity and survival in 1484 patients in New York City. Disease severity was assessed by generating a severity scale, which included multiple laboratory and clinical metrics such as chest X-ray imaging and oxygen therapy modality. The authors found that IL-6 (p
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