Association of TNF-α, TGF-β1, amphiregulin, IL-2, and EGFR WITH pulmonary fibrosis in COVID-19

Pulmonary fibrosis is a well-recognized sequela associated with coronavirus disease 2019 (COVID-19), however the mechanism is yet to be clearly understood. The study was designed to evaluate the association of TNF-α, TGF- β1, amphiregulin, IL-2, and EGFR with pulmonary fibrosis after COVID-19 pneumonia. Non-severe, severe, and critical COVID-19 pneumonia patients were included in this study after the patients agreed and gave written informed consent. Blood samples were analyzed with the ELISA method for cytokine examination. The non-contrast chest CT scan was performed after patients were discharged from hospital. Seventy-nine patients with a mean age of 54 years (57 % men, 43 % women) were fully evaluated. Pulmonary fibrosis was found in 74 patients (93.7 %). Serum levels of TGF-β1 60.55 pg/mL (11.42–2001.16), TNF-α 13.31 pg/mL (3.54–200.32), EGFR 14.9 pg/mL(6.4–53.6), IL-2 12.41 pg/mL(11–14.13), amphiregulin 156.5 pg/mL (21.7–1234). Serum levels of TNF-α increase according to the severity of clinical classification. A significant association between serum levels of TGF-β1, TNF- α, and pulmonary fibrosis with rs-0.247, p = 0.027; rs 0.259, p = 0.046 was found. According to this study, TNF-α and TGF-β1 potentially participate in the process of pulmonary fibrosis in COVID-19.