Blood inflammatory markers and cytokines in patients with COVID-19 and
bacterial coinfections
Abstract
Background: Bacterial coinfection in patients with SARS-CoV-2 infection
is an important risk factor for death. This study investigated and
analyzed whether there were differences in levels of serum inflammatory
markers in patients with SARS-CoV-2 and bacterial coinfection compared
with those without bacterial infection. Methods: A total of 121
inpatients with SARS-CoV-2 infection admitted to Qingdao Central
Hospital from December 7, 2022, to February 7, 2023, were included.
Patients were divided into a bacteria-positive group (61 cases) and a
bacteria-negative group (60 cases) according to whether they had
bacterial infections. PCT, CRP, and 12 cytokines were compared between
groups, and the composition of bacterial species in the positive group
was statistically analyzed. Results: The serum levels of CRP (Z = 3.95,
P < 0.001), PCT (Z = 3.20, P = 0.001), IL-1β (t = 2.90, P =
0.008), IL-2 (t = 3.83, P = 0.001), IL-12p70 (t = 3.28, P = 0.004),
IL-17 (t = 2.22, P = 0.039) and TNF-α (t = 3.02, P = 0.007) between the
two groups were significantly different. IL-17 increased more
significantly than other markers, while IL-6, IL-8, IL-10, interferon-α,
interferon-γ, IL-4 and IL-5 were not statistically significant (P
> 0.05). Among the 61 bacteria-positive patients, 27
patients were positive for one species, mainly Staphylococcus aureus,
Haemophilus influenzae, and Acinetobacter baumannii. Eleven patients
were two species positive, and Acinetobacter baumannii combined with
Pseudomonas aeruginosa was common. Conclusions: Serum PCT and CRP levels
in SARS-CoV-2-infected patients with bacterial coinfection are higher
than those in patients without bacterial infection. Cytokines such as
IL-1β, IL-2, IL-12 p70, IL-17, and TNF-α may be involved in the
progression of COVID-19 combined with bacterial infection. They can be
used as potential markers to evaluate the disease condition and
prognosis.