IL-17A in COVID-19 Cases: a meta-analysis.

Sukayna Fadlallah,Elias A Rahal,Marcel S Sham Eddin

doi:10.3855/jidc.15285

Sukayna Fadlallah, Elias A Rahal + Show 1 more

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https://doi.org/10.3855/jidc.15285

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Abstract

Numerous reviews, commentaries and opinion pieces have suggested targeting IL-17A as part of managing Coronavirus disease 2019 (COVID-19), the notorious pandemic caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). IL-17A is a proinflammatory cytokine attributed with homeostatic roles but that is also involved in autoimmune disease pathogenesis. While some studies have reported an increase in IL-17A in COVID-19 cases, no significant associations were found by others. Hence, we undertook this meta-analysis to study serum IL-17A levels in COVID-19 patients in relation to disease severity. Multiple databases were systematically reviewed for literature published on the topic from January 1, 2019 to April 30, 2021. A random effects model was used to calculate weighted mean differences (WMDs) and 95% confidence interval (CIs) as well as the t2 and I2 statistics for heterogeneity analysis. We report that IL-17A increases in COVID-19 subjects irrespective of disease severity compared to controls [WMD = 2.51 pg/ml (95% CI 1.73-3.28), p < 0.00001]. It is also higher in patients with moderate disease compared to controls [WMD = 2.41 pg/ml (95% CI:1.40-3.43), p < 0.00001] as well as higher in patients with severe COVID-19 [WMD = 4.13 pg/ml (95% CI:1.65-6.60), p = 0.001]. While the increase in serum levels in subjects with severe disease over those with moderate disease was statistically significant, the association was not as robust as the other comparisons [WMD = 2.07 pg/ml (95% CI:0.20-3.95), p = 0.03]. Variable heterogeneity was observed in the various analyses with no significant publication bias detected. Hence, IL-17A may be of relevance when considering management approaches to COVID-19.

Highlights

Numerous reviews, commentaries and opinion pieces have suggested targeting IL-17A as part of managing Coronavirus disease 2019 (COVID-19), the notorious pandemic caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Infection with SARS-CoV-2 has been reported to result in increased levels of Creactive protein, IL-1β, IL1-RA, IL-7, IL-2, IL-6, IL-8, IL-9, IL-10, GCSF, GMCSF, IFNγ, IP10, MCP1, MIP1A, MIP1B, PDGF, TNFα, and VEGF
Comparisons between severely affected individuals and those who were non-severe cases showed higher leukocyte and neutrophil counts but lower lymphocyte levels along with higher IL-2, IL-6, IL-7, IL-8, IL-10, GSCF, IP10, MCP1, MIP1A, and TNFα levels in the severe cases indicating a cytokine storm resulting in hyperinflammation [5,6]

Summary

Introduction

Commentaries and opinion pieces have suggested targeting IL-17A as part of managing Coronavirus disease 2019 (COVID-19), the notorious pandemic caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While some studies have reported an increase in IL-17A in COVID-19 cases, no significant associations were found by others. We undertook this metaanalysis to study serum IL-17A levels in COVID-19 patients in relation to disease severity. Results: We report that IL-17A increases in COVID-19 subjects irrespective of disease severity compared to controls [WMD = 2.51 pg/ml (95% CI 1.73-3.28), p < 0.00001]. While the increase in serum levels in subjects with severe disease over those with moderate disease was statistically significant, the association was not as robust as the other comparisons [WMD = 2.07 pg/ml (95% CI:0.20-3.95), p = 0.03].

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