Which cytokines are most elevated during CSS?
Multiple proinflammatory cytokines and inflammasome activation may contribute to CSS pathogenesis.49 Elevated serum ferritin, IL-6, IL-1β, IFN-γ, CXCL10 (known as IP-10) and CCL2 (known as MCP-1) levels have been observed in the pathogenesis of severe COVID-19.50,70 A recent study compared 48 cytokines in 53 COVID-19 patients and 8 healthy individuals and found that 14 of them were increased in COVID-19: IFN-γ, IL-1Rα, IL-2Rα, IL-6, IL-10, IL-18, hepatocyte growth factor, monocyte chemotactic protein-3, monokine induced γ-IFN, macrophage colony-stimulating factor, granulocyte colony-stimulating factor, macrophage inflammatory protein 1α, cutaneous T-cell-attracting chemokine and IP-10. A consistently high level of IP-10, monocyte chemotactic protein-3 and IL-1Rα was associated with deterioration and fatal outcome.71