key: cord-0945903-egh2xa7h
authors: Wang, Changsong; Kang, Kai; Lan, Xiuwen; Fei, Dongsheng; Wang, Qian; Li, Xianyong; Chong, Yang; Gao, Yan; Wang, Huaiquan; Li, Xueting; Zhao, Mingyan; Yu, Kaijiang
title: Cytokinelevels in sputum, not serum, may be more helpful 1 for indicating the damage in the lung and the prognosis of severe COVID-19 – A Case Series
date: 2021-08-19
journal: J Infect
DOI: 10.1016/j.jinf.2021.08.026
sha: 9815b156b816fb83485de837efd6774e87fd538c
doc_id: 945903
cord_uid: egh2xa7h

PURPOSE: To describe the relationship between the severity of lung damage and cytokine levels in sputum, bronchoalveolar lavage fluid (BALF), serum. METHOD: Eight severe patients infected with coronavirus disease 2019 (COVID-19) were admitted and their cytokines and chest computed tomography (CT) were analyzed. RESULTS: Compared with in serum, IL-6 and TNF-α in sputum and in BALF show more directly reflect the severity of COVID-19 critical patients. The gradient ratio of IL-6 levels may predict the prognosis of severe patients. CONCLUSION: Cytokine levels in the sputum may be more helpful for indicating lung damage. Local intervention through the respiratory tract is expected to benefit patients with severe COVID-19.

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The levels of IL-6, IL-10, and TNF-α in sputum and in BALF from both lungs were 74 detected. The sputum sample of patient #3 and the sputum sample from the left bronchus of 75 patient #8 was not obtained during bronchoscopy. Except for #1, IL-6 and TNF-α levels in 76 sputum are slightly higher than that in BALF with small differences but significantly higher than 77 that in serum. The IL-6 levels in BALF and in sputum of three patients who died of COVID (Table 2 ). In addition, levels of IL-6 and TNF-α in sputum and in BALF are related to the 83 severity of lung injury. Except for #7 (CT shows both lungs are extensively affected, but 84 cytokine levels of the left lung are higher than that of the right lung), the cytokine levels in 

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