The COVID19 pandemic has caused more than a million of deaths worldwide, primarily due to complications from COVID19-associated acute respiratory distress syndrome (ARDS). Controversy surrounds the circulating cytokine/chemokine profile of COVID19-associated ARDS, with some groups suggesting that it is similar to non-COVID19 ARDS patients and others observing substantial differences. Moreover, while a hyperinflammatory phenotype associates with higher mortality in non-COVID19 ARDS, there is little information on the inflammatory landscape's association with mortality in COVID19 ARDS patients. Even though the circulating leukocytes' transcriptomic signature has been associated with distinct phenotypes and outcomes in critical illness including ARDS, it is unclear whether the mortality-associated inflammatory mediators from COVID19 patients are transcriptionally regulated in the leukocyte compartment. Here, we conducted a prospective cohort study of 41 mechanically ventilated patients with COVID19 infection using highly calibrated methods to define the levels of plasma cytokines/chemokines and their gene expressions in circulating leukocytes. Plasma IL1RA and IL8 were found positively associated with mortality while RANTES and EGF negatively associated with that outcome. However, the leukocyte gene expression of these proteins had no statistically significant correlation with mortality. These data suggest a unique inflammatory signature associated with severe COVID19.

中文翻译：

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独特的炎症特征与 SARS-CoV-2 急性呼吸窘迫综合征 (ARDS) 死亡率较高相关

新冠病毒大流行已在全球造成超过一百万人死亡，主要原因是与新冠病毒相关的急性呼吸窘迫综合征（ARDS）并发症。围绕与 COVID19 相关的 ARDS 的循环细胞因子/趋化因子谱存在争议，一些团体认为它与非 COVID19 ARDS 患者相似，而其他团体则观察到实质性差异。此外，虽然高炎症表型与非 COVID19 ARDS 患者的较高死亡率相关，但关于炎症状况与 COVID19 ARDS 患者死亡率之间关系的信息却很少。尽管循环白细胞的转录组学特征与包括 ARDS 在内的危重疾病的不同表型和结果相关，但尚不清楚来自 COVID19 患者的与死亡相关的炎症介质是否在白细胞区室中受到转录调节。在这里，我们使用高度校准的方法对 41 名机械通气的 COVID19 感染患者进行了一项前瞻性队列研究，以确定血浆细胞因子/趋化因子的水平及其在循环白细胞中的基因表达。血浆 IL1RA 和 IL8 与死亡率呈正相关，而 RANTES 和 EGF 与该结果呈负相关。然而，这些蛋白质的白细胞基因表达与死亡率没有统计学上显着的相关性。这些数据表明与严重的新冠病毒相关的独特炎症特征。