Definition and Risks of Cytokine Release Syndrome in 11 Critically Ill COVID-19 Patients With Pneumonia: Analysis of Disease Characteristics

  1. Wenjun Wang
  2. Xiaoqing Liu
  3. Sipei Wu
  4. Sibei Chen
  5. Yimin Li
  6. Lingbo Nong
  7. Puyi Lie
  8. Liyan Huang
  9. Linling Cheng
  10. Yongping Lin
  11. Jianxing He

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Abstract

Corona virus disease 2019 (COVID-19) patients with severe immune abnormalities are at risk of cytokine release syndrome (CRS). The definition, prevention, and treatment of symptoms of CRS in critically ill patients with COVID-19 are important problems. We report a single-center case series of 11 COVID-19 patients with acute respiratory distress syndrome from The First Affiliated Hospital of Guangzhou Medical University in China from 26 January 2020 to 18 February 2020. The termination date of follow-up was 19 February 2020. Eight patients were determined to have characteristics of CRS, including pulmonary inflammation, fever, and dysfunction of nonpulmonary organs. An increase in interleukin-6 in peripheral blood was the highest risk factor and an early indicator of CRS in COVID-19.

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  1. Version published to 10.1093/infdis/jiaa387
  2. ScreenIT

    SciScore for 10.1101/2020.02.26.20026989: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: We obtained verbal consent from each patient.
    IRB: This series of cases was approved by the ethics committee of the First Affiliated Hospital of Guangzhou Medical University.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The frequency of various subsets of T cells was determined using FlowJo software (v10; TreeStar, Ashland, OR, USA).
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. First, we only studied 11 critical patients in a single center and we were unable to conduct a group comparison study. Additional data from critical patients in China would be useful. Second, due to the strong infectivity of the virus, we were not able to construct a COVID-19-infected pneumonia animal model. A validated model could help clarify the molecular mechanism of CRS caused by viral pneumonia. Third, we have not finished the clinical experiment on the treatment of COVID-19-infected pneumonia with IL-6 monoclonal antibody.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.02.26.20026989v1 on medRxiv