Role of tumor necrosis factor-a in the mortality of hospitalized patients with severe and critical COVID-19 pneumonia

The coronavirus disease 2019 (COVID-19) is presently the most pressing public health concern worldwide. Cytokine storm is an important factor leading to death of patients with COVID-19. This study aims to characterize serum cytokines of patients with severe or critical COVID-19. Clinical records were obtained from 149 patients who were tested at the Sino-French New City Branch of Tongji Hospital from 30 January to 30 March 2020. Data regarding the clinical features of the patients was collected and analyzed. Among the 149, 45 (30.2%) of them had severe conditions and 104 (69.8%) of that presented critical symptoms. In the meantime, 80 (53.7%) of that 149 died during hospitalization. Of all, male patients accounted for 94 (69.1%). Compared with patients in severe COVID-19, those who in critical COVID-19 had significantly higher levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-8, and IL-10. Moreover, the passed-away patients had considerably higher levels of TNF-alpha, IL-6, IL-8, and IL-10 than those survived from it. Regression analysis revealed that serum TNF-alpha level was an independent risk factor for the death of patient with severe conditions. Among the proinflammatory cytokines (IL-1 beta, TNF-alpha, IL-8, and IL-6) analyzed herein, TNF-alpha was seen as a risk factor for the death of patients with severe or critical COVID-19. This study suggests that anti-TNF-alpha treatment allows patients with severe or critical COVID-19 pneumonia to recover.

Automated summary

The study suggests that cytokine levels are associated with the mortality risk of patients with severe or critical COVID-19, with TNF-alpha identified as one of the risk factors for patient death. Anti-TNF-alpha treatment may help patients with severe or critical COVID-19 pneumonia recover.