{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:09:04Z","timestamp":1790676544552,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T00:00:00Z","timestamp":1607558400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ALF agreement","award":["ALFGBG-717531"],"award-info":[{"award-number":["ALFGBG-717531"]}]},{"DOI":"10.13039\/501100009252","name":"Science for Life Laboratory","doi-asserted-by":"publisher","award":["KAW 2020.0182"],"award-info":[{"award-number":["KAW 2020.0182"]}],"id":[{"id":"10.13039\/501100009252","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, is rapidly spreading worldwide. There is limited information about prognostic markers that could help clinicians to identify COVID-19 patients with a poor prognosis. Serum levels of the immune activation marker neopterin has shown to be of prognostic value in patients with SARS. The aim of this study was to investigate whether serum neopterin is associated with the severity of COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 34 patients with confirmed COVID-19 between March 3 and March 30, 2020. Fifteen patients had mild disease and did not require hospitalization, whereas 19 patients developed severe COVID-19 requiring intensive care. Concentrations of serum neopterin, tryptophan, and kynurenine were measured at and repeatedly after inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found a more than two-fold higher mean concentration of neopterin in severely ill patients (mean value 42.0\u2009nmol\/L (SD 18.2)) compared to patients with mild symptoms (16.9\u2009nmol\/L (SD 11.0)). All of the severe cases had elevated neopterin concentrations (&gt;\u20099.1\u2009nmol\/L) at the initial sampling with values ranging from 17.2 to 86.7\u2009nmol\/L. In comparison, 10 of 15 patients with mild disease had neopterin levels above 9.1\u2009nmol\/L, with concentrations in the range from 4.9 to 31.6\u2009nmol\/L. Neopterin levels gradually decreased during the course of COVID-19, but severe cases maintained elevated levels for a longer period. Moreover, lower levels of tryptophan and higher levels of kynurenine, indicating an increased tryptophan catabolism, were seen in the group with severe cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In conclusion, we found that serum neopterin levels are associated with the severity of COVID-19. Our findings suggest that neopterin could be used as a prognostic marker, but further studies are needed to elucidate how it can be used in the clinic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-020-05671-7","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T06:03:40Z","timestamp":1607580220000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Serum neopterin levels in relation to mild and severe COVID-19"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2167-6822","authenticated-orcid":false,"given":"Josefina","family":"Robertson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M.","family":"Gostner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staffan","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars-Magnus","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Gisslen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"key":"5671_CR1","unstructured":"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019."},{"key":"5671_CR2","doi-asserted-by":"publisher","unstructured":"Zunyou W, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020. In press. https:\/\/doi.org\/10.1001\/jama.2020.2648.","DOI":"10.1001\/jama.2020.2648"},{"key":"5671_CR3","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.clim.2005.03.009","volume":"116","author":"B Zheng","year":"2005","unstructured":"Zheng B, Cao KY, Chan CPY, et al. Serum neopterin for early assessment of severity of severe acute respiratory syndrome. Clin Immunol. 2005;116:18\u201326. https:\/\/doi.org\/10.1016\/j.clim.2005.03.009.","journal-title":"Clin Immunol"},{"key":"5671_CR4","doi-asserted-by":"publisher","first-page":"175","DOI":"10.2174\/1389200024605082","volume":"3","author":"C Murr","year":"2002","unstructured":"Murr C, Widner B, Wirleitner B, Fuchs D. Neopterin as a marker for immune system activation. 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Participants were enrolled after written informed consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"942"}}