Title : The severity of COVID-19 shifts the cytokine and chemokine milieu toward the proinflammatory environment
Cytokine storm, the production of many pro-and inflammatory cytokines such as IL-1, IL-6, and TNF-a, is linked to the severity of illness associated with COVID-19. Several recent studies have found varying levels of inflammatory cytokines in COVID-19 patients' plasma, primarily related to severe infection. These studies, however, neither analyzed the entire storm nor compared it in patients with different degrees of severity. We designed this study to evaluate the cytokine/chemokine axis related to cytokine storms. To this end, we used a highly standardized Luminex assay to analyze 25 cytokines/chemokines in plasma from 89 male and female patients with different degrees of COVID-19. The patients were divided into five categories based on the severity of their COVID-19 symptoms: healthy, mildly infected, moderately ill, severely ill, and critically ill. The cytokines/chemokines axis evaluated include those associated with inflammation, thrombosis, lung injury, and immunological modulation. Our research revealed substantial variations in many cytokines. IL-2R, IL-8, IL-13, IL-1-α, IL-8, TNF-, and IP10 levels were significantly altered in severe and critically ill patients compared to other groups. Our findings could open new avenues to use these cytokines/ chemokines as a predictor or prognostic biomarker for the severity of COVID-19 and their responses to treatment.