Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis

BACKGROUND. Elevated levels of inflammatory cytokines have been associated with poor outcomes among COVID-19 patients. It is unknown, however, how these levels compare with those observed in critically ill patients with acute respiratory distress syndrome (ARDS) or sepsis due to other causes. METHODS. We used a Luminex assay to determine expression of 76 cytokines from plasma of hospitalized COVID-19 patients and banked plasma samples from ARDS and sepsis patients. Our analysis focused on detecting statistical differences in levels of 6 cytokines associated with cytokine storm (IL-1 beta, IL-1RA, IL-6, IL-8, IL-18, and TNF-alpha) between patients with moderate COVID-19, severe COVID-19, and ARDS or sepsis. RESULTS. Fifteen hospitalized COVID-19 patients, 9 of whom were critically ill, were compared with critically ill patients with ARDS (n = 12) or sepsis (n = 16). There were no statistically significant differences in baseline levels of IL-1 beta, IL-1RA, IL-6, IL-8, IL-18, and TNF-alpha between patients with COVID-19 and critically ill controls with ARDS or sepsis. CONCLUSION. Levels of inflammatory cytokines were not higher in severe COVID-19 patients than in moderate COVID-19 or critically ill patients with ARDS or sepsis in this small cohort. Broad use of immunosuppressive therapies in ARDS has failed in numerous Phase 3 studies; use of these therapies in unselected patients with COVID-19 may be unwarranted.