Link Between Viral Load and Cytokine Response in Severe Influenza
Author Information
Author(s): Raquel Almansa, Anton Andres, Paula Ramirez, Ignacio Martin-Loeches, David Banner, Tomás Pumarola, Luoling Xu, Jesús Blanco, Longsi Ran, Guillermo Lopez-Campos, Fernando Martin-Sanchez, Lorenzo Socias, Ana Loza, David Andaluz, Enrique Maravi, Mónica Gordón, Maria C Gallegos, Victoria Fernandez, Cristobal León, Pedro Merino, Maria Ángeles Marcos, Francisco Gandía, Felipe Bobillo, Salvador Resino, Jose Mª Eiros, Carmen Castro, Paula Mateo, Milagros Gonzalez-Rivera, Jordi Rello, Raul Ortiz de Lejarazu, David J Kelvin, Jesus F Bermejo-Martin
Primary Institution: Hospital Clínico Universitario-IECSCYL
Hypothesis
What is the relationship between host cytokine responses and viral levels in critically ill patients with pandemic influenza?
Conclusion
The study found a direct association between viral replication and host cytokine response in patients with severe respiratory disease caused by the 2009 pandemic influenza virus.
Supporting Evidence
- Viral load was 300 fold higher in patients with the worst respiratory condition.
- Pharyngeal viral load correlated with plasma levels of pro-inflammatory cytokines.
- Patients with severe disease showed high levels of cytokines and chemokines.
- Most patients had no specific antibodies against the pandemic virus at admission.
- Steroidal treatment did not impact pharyngeal viral load.
Takeaway
When people get really sick from the flu, their bodies make a lot of chemicals to fight the virus, and the more virus there is, the more chemicals they make.
Methodology
The study included 23 ICU patients with primary viral pneumonia, measuring pharyngeal viral load and cytokine responses using quantitative PCR and multiplex assays.
Potential Biases
Potential bias due to non-standardized treatment decisions made by attending physicians.
Limitations
The study was limited by the small sample size and the lack of standardized treatment protocols.
Participant Demographics
The cohort included 15 patients requiring mechanical ventilation and 8 patients not requiring it, with a mix of genders and various underlying health conditions.
Statistical Information
P-Value
p<0.05
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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