The Clinical Data Analysis And Cytokine Levels Of Patients With Coronavirus Intracranial Infection

ObjectiveTo study the clinical features of patients with coronavirus intracranial infection at the Children’s Hospital of Chenzhou,and the expression of cytokines in children with coronavirusintracranial infection and coronavirus respiratory tract infection.Methods Samples were collected in the Children’s Hospital of Chenzhou from May 2014 to September 2015.Blood specimens and cerebrospinal fluid(CSF)specimens were collected from hospitalized patients,who were clinically diagnosed of acute viral encephalitis,meningitis and meningoencephalitis.Besides,blood specimens of the children infected with acute respiratory tract were collected.Enzyme-linked immunosorbent assay(ELISA)was used to identify the coronavirus(CoV)in blood and CSF.Luminex system was used to detecte the expression levels of multiple cytokines(IL-1b,IL-2,IL-4,IL-5,IL-6,IL-7,IL-8,IL-10,IL-12,IL-13,IL-17,G-CSF,G M-CSF,IFN-γ,MCP-1,TNF-α,MIP-1β)in the blood and CSF of Co V intracranial infected children,and in the blood of children with respiratory tract infection and control group.Thus the clinical characteristics of this disease and the expression of cytokines were analyzed,combining with the test results and related case data.Results1.Anti-CoV IgM antibodies were detected in 26/245(10.61%)in CSF and 30/295(10.17%)in blood among patients with acute encehalitis-like syndromeand acute respiratory infection,respectively.2.The common manifestations of CoV intracranial infection were fever(76.9%),headache(46.2%),vomiting(34.6%),convulsions(23.1%);8 patients(8/20)of CoV intracranial infection group had imaging changes in brain(MRI or CT);12 patients had CSF changes;and 1 patient was at abnormal EEG expression(1/4).3.26 cases of CoV intracranial infection children had a median duration of hospital stays for 15.50(10.50-23.50)days,and all of them were cured and discharged.4.Our results showed that lymphocyte counts were significantly lower in CoV intracranial infection group than either CoV-respiratory tract infection(p=0.003)or healthy control group(p=0.041);eosinophil counts were distinctlylower in CoV intracranial infection group than either CoV-respiratory tract infection(p=0.041)or healthy control group(p=0.031);neutrophil cells count was visibly higher inCoV intracranial infection thanCoV-respiratory tract infection(p=0.003).Monocytes count was obviously higher in CoV intracranial infection compared to healthy control group(p=0.031).5.The plasma concentrations of G-CSF in children with CoV intracranial infectiongroup and Co V respiratory tract infectiongroup were higher than those in healthy control group(p=0.005;p=0.004).plasma level of GM-CSF was significantly higherin CoV intracranial infection comparedto either CoV-respiratory tract infection(p=0.004)or healthy controls(p=0.001);6.Comparisons between plasma and CSF samples of patients with CoV intracranial infection,the expression levels of IL-6(p=0.003),IL-8(p=0.002),MCP-1(p=0.001)and GM-CSF(p=0.025)were significantly higher in CSF than in plasma,while the expression levels of MIP-1β(p = 0.027)were significantly lower in CSF than in plasma.Conclusions1.The clinical manifestations of CoV intracranial infection mainly include fever,headache,vomiting and convulsions.CoV intracranial infectionusually have a good prognosis.2.The plasma concentrations of G-CSF and GM-CSF in children with CoV intracranial infectiongroupare significantly higher than those in healthy control group.Expression levels of IL-6,IL-8,MCP-1and GM-CSF are significantly higher in CSF than in plasma,while the expression levels of MIP-1β are significantly lower in CSF than in plasma.This results are likely related to immunological mechanism.