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Updated: Oct 21, 2025

Author Spotlight: Unveiling the Polyfunctionality and Heterogeneity in Immune Responses
Published on: March 8, 2024
Cytokine Signature Associated With Disease Severity in COVID-19
Jing Guo1, Shuting Wang1, He Xia1
1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Insights
Cytokine levels in COVID-19 patients correlate with disease severity and progression. Specific cytokines like IP-10 and M-CSF can predict severe outcomes, aiding early intervention for better prognosis.
Area of Science:
- Immunology
- Infectious Diseases
- Biomarker Discovery
Background:
- Coronavirus disease 2019 (COVID-19) emerged as a global epidemic, necessitating early identification of disease severity and pathogenesis.
- Understanding the host immune response, particularly cytokine profiles, is crucial for managing COVID-19 progression.
Purpose of the Study:
- To identify novel cytokine and chemokine biomarkers for predicting COVID-19 severity and progression.
- To investigate the correlation between cytokine levels and clinical parameters in COVID-19 patients.
Main Methods:
- Analyzed 48 cytokines and chemokines in 75 COVID-19 patients, 34 healthy controls, and 23 influenza A(H1N1) patients using liquid chip technology.
- Correlated cytokine levels with clinical severity scores (APACHE II), viral titers, and laboratory markers (creatinine, troponin I, INR, procalcitonin).
- Performed univariate analyses to identify cytokines associated with COVID-19 severity.
Main Results:
- 33 cytokines were significantly elevated in COVID-19 patients compared to healthy controls.
- HGF and IL-1β correlated with APACHE II scores; IP-10, HGF, and IL-10 correlated with virus titers.
- Six cytokines (G-CSF, HGF, IL-10, IL-18, M-CSF, SCGF-β) were associated with COVID-19 severity, with IP-10 and M-CSF showing excellent predictive value.
Conclusions:
- Elevated serum cytokine levels in the early stages of COVID-19 are significantly correlated with disease severity.
- Cytokines serve as valuable warning indicators for COVID-19 severity and progression.
- Early disease stratification and interventions targeting hypercytokinemia may improve patient prognosis.
Abstract:
Coronavirus disease 2019 (COVID-19) broke out and then became a global epidemic at the end of 2019. With the increasing number of deaths, early identification of disease severity and interpretation of pathogenesis are very important. Aiming to identify biomarkers for disease severity and progression of COVID-19, 75 COVID-19 patients, 34 healthy controls and 23 patients with pandemic influenza A(H1N1) were recruited in this study. Using liquid chip technology, 48 cytokines and chemokines were examined, among which 33 were significantly elevated in COVID-19 patients compared with healthy controls. HGF and IL-1β were strongly associated with APACHE II score in the first week after disease onset. IP-10, HGF and IL-10 were correlated positively with virus titers. Cytokines were significantly correlated with creatinine, troponin I, international normalized ratio and procalcitonin within two weeks after disease onset. Univariate analyses were carried out, and 6 cytokines including G-CSF, HGF, IL-10, IL-18, M-CSF and SCGF-β were found to be associated with the severity of COVID-19. 11 kinds of cytokines could predict the severity of COVID-19, among which IP-10 and M-CSF were excellent predictors for disease severity. In conclusion, the levels of cytokines in COVID-19 were significantly correlated with the severity of the disease in the early stage, and serum cytokines could be used as warning indicators of the severity and progression of COVID-19. Early stratification of disease and intervention to reduce hypercytokinaemia may improve the prognosis of COVID-19 patients.
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