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In Frontiers in medicine

COVID-19 is a disease caused by the novel Coronavirus SARS-CoV-2 causing an acute respiratory disease that can eventually lead to severe acute respiratory syndrome (SARS). An exacerbated inflammatory response is characteristic of SARS-CoV-2 infection, which leads to a cytokine release syndrome also known as cytokine storm associated with the severity of the disease. Considering the importance of this event in the immunopathology of COVID-19, this study analyses cytokine levels of hospitalized patients to identify cytokine profiles associated with severity and mortality. Using a machine learning approach, 3 clusters of COVID-19 hospitalized patients were created based on their cytokine profile. Significant differences in the mortality rate were found among the clusters, associated to different CXCL10/IL-38 ratio. The balance of a CXCL10 induced inflammation with an appropriate immune regulation mediated by the anti-inflammatory cytokine IL-38 appears to generate the adequate immune context to overrule SARS-CoV-2 infection without creating a harmful inflammatory reaction. This study supports the concept that analyzing a single cytokine is insufficient to determine the outcome of a complex disease such as COVID-19, and different strategies incorporating bioinformatic analyses considering a broader immune profile represent a more robust alternative to predict the outcome of hospitalized patients with SARS-CoV-2 infection.

Castro-Castro Ana Cristina, Figueroa-Protti Lucia, Molina-Mora Jose Arturo, Rojas-Salas María Paula, Villafuerte-Mena Danae, Suarez-Sánchez María José, Sanabría-Castro Alfredo, Boza-Calvo Carolina, Calvo-Flores Leonardo, Solano-Vargas Mariela, Madrigal-Sánchez Juan José, Sibaja-Campos Mario, Silesky-Jiménez Juan Ignacio, Chaverri-Fernández José Miguel, Soto-Rodríguez Andrés, Echeverri-McCandless Ann, Rojas-Chaves Sebastián, Landaverde-Recinos Denis, Weigert Andreas, Mora Javier


COVID-19, CXCL10, IL-38, SARS-CoV-2, cytokine profile