Clinical characteristics of 34 COVID-19 patients admitted to ICU in Hangzhou, China

Yi Zheng; Lijun Sun; Mi Xu; Jian Pan; Yuntao Zhang; Xueling Fang; Qiang Fang; Hongliu Cai

We noted that SARS-CoV-2 infection caused increase in plasma IL-6 levels, which were consistently at a high levels in IMV cases in our cohort. Early studies also have shown that increased concentrations of proinflammatory cytokines (eg, IL-6, TNFα and IFNγ) in SARS patients [20] and MERS-CoV cases [21] . Increased amounts of anti-inflammatory cytokine, IL-10, in plasma was found in SARS-CoV-2 infected patients with IMV, which differs from SARS-CoV infection [12] , but supported by Huang et al. [8] in patients with the same disease. BUN is a key element reflecting the intricate interrelation between nutritional status, protein metabolism and renal situation of the patient [22] . BUN were significantly elevated in IMV patients compared with NIV cases which may cause by high catabolism. The characteristics of inflammation and metabolism, combined with lymphocytopenia, suggested that we have to be on the alert of the existence of persistent inflammation-immunosuppression and catabolism syndrome (PICS) in IMV cases. PICS, often leading to secondary infections and/or viral reactivation in the critically ill, has been associated with increased morbidity and mortality [23] [24] [25] .