Clinical Progression and Cytokine Profiles of Middle East Respiratory Syndrome Coronavirus Infection
Identifieur interne : 000C28 ( Pmc/Checkpoint ); précédent : 000C27; suivant : 000C29Clinical Progression and Cytokine Profiles of Middle East Respiratory Syndrome Coronavirus Infection
Auteurs : Eu Suk Kim ; Pyoeng Gyun Choe ; Wan Beom Park ; Hong Sang Oh ; Eun Jung Kim ; Eun Young Nam ; Sun Hee Na ; Moonsuk Kim ; Kyoung-Ho Song ; Ji Hwan Bang ; Sang Won Park ; Hong Bin Kim ; Nam Joong Kim ; Myoung-Don OhSource :
- Journal of Korean Medical Science [ 1011-8934 ] ; 2016.
Abstract
Clinical progression over time and cytokine profiles have not been well defined in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. We included 17 patients with laboratory-confirmed MERS-CoV during the 2015 outbreak in Korea. Clinical and laboratory parameters were collected prospectively. Serum cytokine and chemokine levels in serial serum samples were measured using enzyme-linked immunosorbent assay. All patients presented with fever. The median time to defervescence was 18 days. Nine patients required oxygen supplementation and classified into severe group. In the severe group, chest infiltrates suddenly began to worsen around day 7 of illness, and dyspnea developed at the end of the first week and became apparent in the second week. Median time from symptom onset to oxygen supplementation was 8 days. The severe group had higher neutrophil counts during week 1 than the mild group (4,500 vs. 2,200/µL,
Url:
DOI: 10.3346/jkms.2016.31.11.1717
PubMed: 27709848
PubMed Central: 5056202
Affiliations:
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<front><div type="abstract" xml:lang="en"><p>Clinical progression over time and cytokine profiles have not been well defined in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. We included 17 patients with laboratory-confirmed MERS-CoV during the 2015 outbreak in Korea. Clinical and laboratory parameters were collected prospectively. Serum cytokine and chemokine levels in serial serum samples were measured using enzyme-linked immunosorbent assay. All patients presented with fever. The median time to defervescence was 18 days. Nine patients required oxygen supplementation and classified into severe group. In the severe group, chest infiltrates suddenly began to worsen around day 7 of illness, and dyspnea developed at the end of the first week and became apparent in the second week. Median time from symptom onset to oxygen supplementation was 8 days. The severe group had higher neutrophil counts during week 1 than the mild group (4,500 vs. 2,200/µL, <italic>P</italic>
= 0.026). In the second week of illness, the severe group had higher serum levels of IL-6 (54 vs. 4 pg/mL, <italic>P</italic>
= 0.006) and CXCL-10 (2,642 vs. 382 pg/mL, <italic>P</italic>
< 0.001). IFN-α response was not observed in mild cases. Our data shows that clinical condition may suddenly deteriorate around 7 days of illness and the serum levels of IL-6 and CXCL-10 was significantly elevated in MERS-CoV patients who developed severe diseases.</p>
</div>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Korean Med Sci</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Korean Med. Sci</journal-id>
<journal-id journal-id-type="publisher-id">JKMS</journal-id>
<journal-title-group><journal-title>Journal of Korean Medical Science</journal-title>
</journal-title-group>
<issn pub-type="ppub">1011-8934</issn>
<issn pub-type="epub">1598-6357</issn>
<publisher><publisher-name>The Korean Academy of Medical Sciences</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27709848</article-id>
<article-id pub-id-type="pmc">5056202</article-id>
<article-id pub-id-type="doi">10.3346/jkms.2016.31.11.1717</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
<subj-group subj-group-type="subheading"><subject>Infectious Diseases, Microbiology & Parasitology</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Clinical Progression and Cytokine Profiles of Middle East Respiratory Syndrome Coronavirus Infection</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-7132-0157</contrib-id>
<name><surname>Kim</surname>
<given-names>Eu Suk</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
<xref ref-type="author-notes" rid="afn1">*</xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-6794-7918</contrib-id>
<name><surname>Choe</surname>
<given-names>Pyoeng Gyun</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
<xref ref-type="author-notes" rid="afn1">*</xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0003-0022-9625</contrib-id>
<name><surname>Park</surname>
<given-names>Wan Beom</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-4535-6305</contrib-id>
<name><surname>Oh</surname>
<given-names>Hong Sang</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0003-3302-7827</contrib-id>
<name><surname>Kim</surname>
<given-names>Eun Jung</given-names>
</name>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0003-2488-3226</contrib-id>
<name><surname>Nam</surname>
<given-names>Eun Young</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-9605-7807</contrib-id>
<name><surname>Na</surname>
<given-names>Sun Hee</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-8640-939X</contrib-id>
<name><surname>Kim</surname>
<given-names>Moonsuk</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-4517-3840</contrib-id>
<name><surname>Song</surname>
<given-names>Kyoung-Ho</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-7628-1182</contrib-id>
<name><surname>Bang</surname>
<given-names>Ji Hwan</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-0550-1897</contrib-id>
<name><surname>Park</surname>
<given-names>Sang Won</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-6262-372X</contrib-id>
<name><surname>Kim</surname>
<given-names>Hong Bin</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-6793-9467</contrib-id>
<name><surname>Kim</surname>
<given-names>Nam Joong</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-2344-7695</contrib-id>
<name><surname>Oh</surname>
<given-names>Myoung-don</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
</contrib-group>
<aff id="A1">Department of Internal Medicine, Seoul National University College of Medicine, Seoul,<country>Korea</country>
.</aff>
<author-notes><corresp>Address for Correspondence: Myoung-don Oh, MD. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. <email>mdohmd@snu.ac.kr</email>
</corresp>
<fn id="afn1" fn-type="equal"><p><sup>*</sup>
Eu Suk Kim and Pyoeng Gyun Choe contributed equally to the work.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>02</day>
<month>9</month>
<year>2016</year>
</pub-date>
<volume>31</volume>
<issue>11</issue>
<fpage>1717</fpage>
<lpage>1725</lpage>
<history><date date-type="received"><day>21</day>
<month>4</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>12</day>
<month>6</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 The Korean Academy of Medical Sciences.</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Clinical progression over time and cytokine profiles have not been well defined in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. We included 17 patients with laboratory-confirmed MERS-CoV during the 2015 outbreak in Korea. Clinical and laboratory parameters were collected prospectively. Serum cytokine and chemokine levels in serial serum samples were measured using enzyme-linked immunosorbent assay. All patients presented with fever. The median time to defervescence was 18 days. Nine patients required oxygen supplementation and classified into severe group. In the severe group, chest infiltrates suddenly began to worsen around day 7 of illness, and dyspnea developed at the end of the first week and became apparent in the second week. Median time from symptom onset to oxygen supplementation was 8 days. The severe group had higher neutrophil counts during week 1 than the mild group (4,500 vs. 2,200/µL, <italic>P</italic>
= 0.026). In the second week of illness, the severe group had higher serum levels of IL-6 (54 vs. 4 pg/mL, <italic>P</italic>
= 0.006) and CXCL-10 (2,642 vs. 382 pg/mL, <italic>P</italic>
< 0.001). IFN-α response was not observed in mild cases. Our data shows that clinical condition may suddenly deteriorate around 7 days of illness and the serum levels of IL-6 and CXCL-10 was significantly elevated in MERS-CoV patients who developed severe diseases.</p>
</abstract>
<abstract abstract-type="graphical"><title>Graphical Abstract</title>
<p><graphic xlink:href="jkms-31-1717-ab001.jpg" position="float" orientation="portrait"></graphic>
</p>
</abstract>
<kwd-group kwd-group-type="author"><kwd>MERS</kwd>
<kwd>Coronavirus</kwd>
<kwd>Clinical Progression</kwd>
<kwd>Cytokine</kwd>
<kwd>Chemokine</kwd>
<kwd>IFN-α</kwd>
<kwd>IL-6</kwd>
<kwd>CXCL-10</kwd>
<kwd>Severity</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="KR"><institution-wrap><institution>Korea Health Industry Development Institute</institution>
<institution-id institution-id-type="CrossRef">http://dx.doi.org/10.13039/501100003710</institution-id>
</institution-wrap>
</funding-source>
<award-id>HI15C3227</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Bang, Ji Hwan" sort="Bang, Ji Hwan" uniqKey="Bang J" first="Ji Hwan" last="Bang">Ji Hwan Bang</name>
<name sortKey="Choe, Pyoeng Gyun" sort="Choe, Pyoeng Gyun" uniqKey="Choe P" first="Pyoeng Gyun" last="Choe">Pyoeng Gyun Choe</name>
<name sortKey="Kim, Eu Suk" sort="Kim, Eu Suk" uniqKey="Kim E" first="Eu Suk" last="Kim">Eu Suk Kim</name>
<name sortKey="Kim, Eun Jung" sort="Kim, Eun Jung" uniqKey="Kim E" first="Eun Jung" last="Kim">Eun Jung Kim</name>
<name sortKey="Kim, Hong Bin" sort="Kim, Hong Bin" uniqKey="Kim H" first="Hong Bin" last="Kim">Hong Bin Kim</name>
<name sortKey="Kim, Moonsuk" sort="Kim, Moonsuk" uniqKey="Kim M" first="Moonsuk" last="Kim">Moonsuk Kim</name>
<name sortKey="Kim, Nam Joong" sort="Kim, Nam Joong" uniqKey="Kim N" first="Nam Joong" last="Kim">Nam Joong Kim</name>
<name sortKey="Na, Sun Hee" sort="Na, Sun Hee" uniqKey="Na S" first="Sun Hee" last="Na">Sun Hee Na</name>
<name sortKey="Nam, Eun Young" sort="Nam, Eun Young" uniqKey="Nam E" first="Eun Young" last="Nam">Eun Young Nam</name>
<name sortKey="Oh, Hong Sang" sort="Oh, Hong Sang" uniqKey="Oh H" first="Hong Sang" last="Oh">Hong Sang Oh</name>
<name sortKey="Oh, Myoung Don" sort="Oh, Myoung Don" uniqKey="Oh M" first="Myoung-Don" last="Oh">Myoung-Don Oh</name>
<name sortKey="Park, Sang Won" sort="Park, Sang Won" uniqKey="Park S" first="Sang Won" last="Park">Sang Won Park</name>
<name sortKey="Park, Wan Beom" sort="Park, Wan Beom" uniqKey="Park W" first="Wan Beom" last="Park">Wan Beom Park</name>
<name sortKey="Song, Kyoung Ho" sort="Song, Kyoung Ho" uniqKey="Song K" first="Kyoung-Ho" last="Song">Kyoung-Ho Song</name>
</noCountry>
</tree>
</affiliations>
</record>
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