{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T06:15:46Z","timestamp":1777702546263,"version":"3.51.4"},"reference-count":70,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Interferon &amp; Cytokine Research"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>\n                    Despite extensive research to decipher the immunological basis of coronavirus disease\n                    <jats:sc>(<\/jats:sc>\n                    COVID-19), limited evidence on immunological correlates of COVID-19 severity from MENA region and Egypt was reported. In a single-center cross-sectional study, we have analyzed 25 cytokines that are related to immunopathologic lung injury, cytokine storm, and coagulopathy in plasma samples from 78 hospitalized Egyptian COVID-19 patients in Tanta University Quarantine Hospital and 21 healthy control volunteers between April 2020 and September 2020. The enrolled patients were divided into 4 categories based on disease severity, namely mild, moderate, severe, and critically ill. Interestingly, interleukin (IL)-1-\u03b1, IL-2R\u03b1, IL-6, IL-8, IL-18, tumor necrosis factor-alpha (TNF-\u03b1), FGF1, CCL2, and CXC10 levels were significantly altered in severe and\/or critically ill patients. Moreover, principal component analysis (PCA) demonstrated that severe and critically ill COVID-19 patients cluster based on specific cytokine signatures that distinguish them from mild and moderate COVID-19 patients. Specifically, levels of IL-2R\u03b1, IL-6, IL-10, IL-18, TNF-\u03b1, FGF1, and CXCL10 largely contribute to the observed differences between early and late stages of COVID-19 disease. Our PCA showed that the described immunological markers positively correlate with high D-dimer and C-reactive protein levels and inversely correlate with lymphocyte counts in severe and critically ill patients. These data suggest a disordered immune regulation, particularly in severe and critically ill Egyptian COVID-19 patients, manifested as overactivated innate immune and dysregulated T-helper1 responses. Additionally, our study emphasizes the importance of cytokine profiling to identify potentially predictive immunological signatures of COVID-19 disease severity.\n                  <\/jats:p>","DOI":"10.1089\/jir.2023.0029","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T11:48:21Z","timestamp":1685447301000},"page":"257-268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["COVID-19 Severity Shifts the Cytokine Milieu Toward a Proinflammatory State in Egyptian Patients: A Cross-Sectional Study"],"prefix":"10.1177","volume":"43","author":[{"given":"Mohamed L.","family":"Salem","sequence":"first","affiliation":[{"name":"Department of Zoology, Faculty of Science, Tanta University, Tanta, Egypt."},{"name":"Center of Excellence in Cancer Research, Teaching Hospital, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madonna M.","family":"Eltoukhy","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasha E.","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Faculty of Medicine, Galala University, Suez, Egypt."},{"name":"Department of Microbiology, and Immunology, Faculty of Medicine, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal M.","family":"Okasha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed R.","family":"El-Shanshoury","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Attia","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed S.","family":"Hantera","sequence":"additional","affiliation":[{"name":"Department of Chest, Faculty of Medicine, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asmaa","family":"Hilal","sequence":"additional","affiliation":[{"name":"Department of Botany and Microbiology, Faculty of Science, Tanta University, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4547-4675","authenticated-orcid":false,"given":"Mohammed A.","family":"Eid","sequence":"additional","affiliation":[{"name":"Department of Botany and Microbiology, Faculty of Science, Tanta University, Tanta, 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