High Plasma Cytokine Levels Linked to Disease Severity in COVID-19

Cytokines are small secreted proteins released by cells have a specific effect on the interactions and communications between cells.
In patients with COVID-19, plasma levels of the cytokines IP-10 and MCP-3 were highly associated with disease severity and progression.

In patients with coronavirus disease 2019 (COVID-19), plasma levels of the cytokines IP-10 and MCP-3 were highly associated with disease severity and progression, according to an analysis published in the Journal of Allergy and Clinical Immunology.  

Researchers conducted a study in Chinese patients diagnosed with COVID-19, which was defined according to the China National Health Commission Guidelines for Diagnosis and Treatment of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. The researchers sought to identify biomarkers that are predictive of disease progression and severity in individuals with COVID-19 infection. They recruited a total of 50 patients with COVID-19; 11 of whom were considered critically ill, 25 as severely ill, and 14 as moderately ill. Overall, 58% of the patients with the infection were men. The median patient age was 62 years (range, 22-78 years). The majority of the critically ill (81.8%) and the patients with severe disease (68%) were ≥60 years, whereas 64.3% of those with moderate disease were between 16 and 59 years. A total of 8 healthy control individuals were also enrolled in the study.

The critically ill patients and those with severe infection exhibited initial symptoms of fever and myalgia, disease complications such as acute respiratory distress syndrome, respiratory failure, and hepatic and renal insufficiency more often than did those with moderate disease. In patients who were considered critically ill, severely ill, and moderately ill, he median duration of hospitalization was 39, 21, and 16 days, respectively.

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Researchers analyzed the expression profiles of various plasma cytokines in combination with clinical data in these individuals. All clinical information and laboratory results were obtained at the earliest time point following hospital admission. The concentration of 48 cytokines in the plasma samples collected from the 50 patients with COVID-19 were measured and assessed. A total of 14 cytokines were significantly elevated in patients with the infection, with different expression profiles revealed based on disease severity.

Expression levels of IP-10, MCP-3, HGF, MIG, and MIP-1α were all shown to be highly associated with severity of COVD-19, which were highest in critically ill patients, followed by those with severe disease, and then by those with moderate disease. In fact, IP-10 and MCP-3 were strong predictors for the progression of COVID-19. The combination of these 2 cytokines demonstrated the largest area under the curve of the receiver-operating characteristics calculations, with a value of 0.99.

The investigators concluded that detecting IP-10 and MCP-3 expression levels in patients with COVID-19 in the early stage of their disease may provide useful information regarding potential therapeutic strategies and targets.


Yang Y, Shen C, Li J, et al. Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19 [published online April 29, 2020]. J Allergy Clin Immunol. doi:10.1016/j.jaci.2020.04.027