Serum Cytokine and Chemokine Profile in Relation to the Severity of Coronavirus Disease 2019 in China

J Infect Dis. 2020 Aug 4;222(5):746-754. doi: 10.1093/infdis/jiaa363.


Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated the serum cytokine and chemokine levels in asymptomatic, mild, moderate, severe, and convalescent SARS-CoV-2-infected cases. Proinflammatory cytokine and chemokine production induced by SARS-CoV-2 were observed not only in symptomatic patients but also in asymptomatic cases, and returned to normal after recovery. IL-6, IL-7, IL-10, IL-18, G-CSF, M-CSF, MCP-1, MCP-3, IP-10, MIG, and MIP-1α were found to be associated with the severity of COVID-19. Moreover, a set of cytokine and chemokine profiles were significantly higher in SARS-CoV-2-infected male than female patients. The serum levels of MCP-1, G-CSF, and VEGF were weakly and positively correlated with viral titers. We suggest that combinatorial analysis of serum cytokines and chemokines with clinical classification may contribute to evaluation of the severity of COVID-19 and optimize the therapeutic strategies.

Keywords: SARS-CoV-2; chemokine; cytokine; disease severity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Chemokine CCL2 / blood
  • Chemokines / blood*
  • Coronavirus Infections / blood*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / immunology
  • Coronavirus Infections / virology
  • Cytokines / blood*
  • Female
  • Granulocyte Colony-Stimulating Factor / blood
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Severity of Illness Index
  • Vascular Endothelial Growth Factor A / blood
  • Viral Load


  • CCL2 protein, human
  • Chemokine CCL2
  • Chemokines
  • Cytokines
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Granulocyte Colony-Stimulating Factor