{"id":19527,"date":"2020-12-05T04:53:11","date_gmt":"2020-12-04T20:53:11","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=19527"},"modified":"2020-12-16T06:14:54","modified_gmt":"2020-12-15T22:14:54","slug":"lancet-respir-med%e5%9c%a8%e7%ba%bf%e5%8f%91%e8%a1%a8%ef%bc%9a%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e%e9%87%8d%e7%97%87%e4%b8%8e%e5%8d%b1%e9%87%8d%e7%97%87%e6%82%a3%e8%80%85%e7%9a%84%e7%bb%86%e8%83%9e","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=19527","title":{"rendered":"[Lancet Respir Med\u5728\u7ebf\u53d1\u8868]\uff1a\u65b0\u51a0\u80ba\u708e\u91cd\u75c7\u4e0e\u5371\u91cd\u75c7\u60a3\u8005\u7684\u7ec6\u80de\u56e0\u5b50"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Cytokine elevation in severe and critical COVID-19: a rapid systematic review, meta-analysis, and comparison with other inflammatory syndromes<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Daniel E Leisman, Lukas Ronner, Rachel Pinotti, et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Lancet Respir Med Published:October 16, 2020 DOI:<a href=\"https:\/\/doi.org\/10.1016\/S2213-2600(20)30404-5\">https:\/\/doi.org\/10.1016\/S2213-2600(20)30404-5<\/a><\/h3>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"seccestitle10\">Summary<\/h2>\n\n\n\n<p>The description of a so-called cytokine storm in patients with COVID-19 has prompted consideration of anti-cytokine therapies, particularly interleukin-6 antagonists. However, direct systematic comparisons of COVID-19 with other critical illnesses associated with elevated cytokine concentrations have not been reported. In this Rapid Review, we report the results of a systematic review and meta-analysis of COVID-19 studies published or posted as preprints between Nov 1, 2019, and April 14, 2020, in which interleukin-6 concentrations in patients with severe or critical disease were recorded. 25 COVID-19 studies (n=1245 patients) were ultimately included. Comparator groups included four trials each in sepsis (n=5320), cytokine release syndrome (n=72), and acute respiratory distress syndrome unrelated to COVID-19 (n=2767). In patients with severe or critical COVID-19, the pooled mean serum interleukin-6 concentration was 36\u00b77 pg\/mL (95% CI 21\u00b76\u201362\u00b73 pg\/mL;\u00a0<em>I<\/em><sup>2<\/sup>=57\u00b77%). Mean interleukin-6 concentrations were nearly 100 times higher in patients with cytokine release syndrome (3110\u00b75 pg\/mL, 632\u00b73\u201315\u2008302\u00b79 pg\/mL; p&lt;0\u00b70001), 27 times higher in patients with sepsis (983\u00b76 pg\/mL, 550\u00b71\u20131758\u00b74 pg\/mL; p&lt;0\u00b70001), and 12 times higher in patients with acute respiratory distress syndrome unrelated to COVID-19 (460 pg\/mL, 216\u00b73\u2013978\u00b77 pg\/mL; p&lt;0\u00b70001). Our findings question the role of a cytokine storm in COVID-19-induced organ dysfunction. Many questions remain about the immune features of COVID-19 and the potential role of anti-cytokine and immune-modulating treatments in patients with the disease.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/els-jbs-prod-cdn.jbs.elsevierhealth.com\/cms\/attachment\/d00824c8-623e-45ca-b9a0-c8b1d3269acd\/gr1.gif\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/els-jbs-prod-cdn.jbs.elsevierhealth.com\/cms\/attachment\/6288d9ab-9b95-4acc-a585-ecf90205220b\/gr2a.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/els-jbs-prod-cdn.jbs.elsevierhealth.com\/cms\/attachment\/77b239da-07a6-408a-8875-e28ba4dfa397\/gr2b.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/els-jbs-prod-cdn.jbs.elsevierhealth.com\/cms\/attachment\/6c79e090-e6a1-430c-b0b7-300fdf6b1e50\/gr3.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/els-jbs-prod-cdn.jbs.elsevierhealth.com\/cms\/attachment\/d5fe8fe8-c95c-4ba6-ae72-ee7228ab0774\/gr4.jpg\" alt=\"\"\/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Cytokine elevation in severe and critical COVID-19: a r [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/19527"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=19527"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/19527\/revisions"}],"predecessor-version":[{"id":19528,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/19527\/revisions\/19528"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=19527"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=19527"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=19527"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}