{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T17:18:17Z","timestamp":1781111897445,"version":"3.54.1"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Intoduction<\/jats:title><jats:p>T lymphocytes, along with cytokines and chemokines-dependent pathways are primarily responsible for regulating the immune response, controlling inflammation and eliminating viral infections. However, excessive immune activity can lead to pathological effects such as cytokine storm, which may cause severe respiratory distress syndrome and multi-organ damage in COVID-19. The aim of this study was to identify potential biomarkers of SARS-CoV-2 infection that could predict the severity of COVID-19 progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The cohort in this study included 52 hospitalized adult patients with SARS-CoV-2 infection from Warsaw, Poland admitted to the hospital during COVID-19 pandemic (February to November 2021). Based on clinical symptoms, patients were divided into two groups: (i) mild\/moderate symptoms (non-severe) \u2013 44 patients and (ii) severe respiratory failure (severe) \u2013 8 patients. The control group consisted of 26 individuals without COVID-19. All COVID-19 patients and healthy controls underwent immunophenotyping of peripheral blood to assess the abundance of T lymphocytes and regulatory T lymphocytes, as well as measurement of selected cytokine and chemokine concentrations in corresponding serum samples. Data analysis was performed using CytoFLEX Flow Cytometer. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Decreased percentages of total lymphocytes and T lymphocytes in peripheral blood were observed across all COVID-19 patients, with varying degrees between the non-severe and severe groups. A significant reduction was also noted in double-positive lymphocytes (CD4+CD8+), regulatory T lymphocytes ( CD4+ CD25HiCD127Lo and CD4+CD25HiCD127LoFoxP3+), as well as CD4+CD25+\/-, CD4+CD45RA+\/-, and CD8+CD45RA+\/- subsets. Elevated levels of IL-6, IL-10, IL-17A, IFN-g, CCL2, CXCL8, and CXCL10 were observed in the non-severe and\/or severe groups compared to healthy controls. Most importantly, only CXCL10 was significantly elevated in the severe group at admission compared to the non-severe group. In this study, we identified the chemokine CXCL10 as a crucial marker for distinguishing the severe course of COVID-19 from non-severe form at the time of admission. It may serve as an early indicator of diseases progression during hospitalization, potentially allowing prediction of the disease course. Moreover, elevated CXCL10 levels, in combination with decreased total lymphocytes counts and increased levels of IL-6, IL10, IFNg, CCL2 and CXCL9, may represent a more comprehensive biomarker panel suitable for predicting the severity of COVID-19.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1613629","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T05:30:28Z","timestamp":1758519028000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Identification of blood immunological biomarkers of SARS-CoV-2 infection during pandemic in Poland"],"prefix":"10.3389","volume":"16","author":[{"given":"Monika","family":"Le\u015bniak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Borkowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"K\u0142os","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Aleksandrowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Por\u0119bska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmara","family":"Kobza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof \u0141ukasz","family":"Piwowarek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Plewka-Barcik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Niemcewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Luty\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek Z.","family":"Kubiak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Chcia\u0142owski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Zdanowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2020.07.034","article-title":"Benefits and limitations of serological assays in COVID-19 infection","volume":"67","author":"Sidiq","year":"2020","journal-title":"Indian J Tuberc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.cytogfr.2020.04.002","article-title":"Cytokine storm intervention in the early stages of COVID-19 pneumonia","volume":"53","author":"Sun","year":"2020","journal-title":"Cytokine Growth Factor Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"206","DOI":"10.3390\/cells10020206","article-title":"COVID-19: characteristics and therapeutics","volume":"10","author":"Chilamakuri","year":"2021","journal-title":"Cells"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2020.1797487","article-title":"Resolution of coronavirus disease 2019 (COVID-19)","volume":"18","author":"Habas","year":"2020","journal-title":"Expert Rev Anti Infect Ther"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4103\/IJPM.IJPM_779_20","article-title":"COVID-19: An up-to-date review - from morphology to pathogenesis","volume":"63","author":"Bal","year":"2020","journal-title":"Indian J Pathol Microbiol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1125246","article-title":"The development of COVID-19 treatment","volume":"14","author":"Yuan","year":"2023","journal-title":"Front Immunol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.01.007","article-title":"Adaptive immunity to SARS-coV-2 and COVID-19","volume":"184","author":"Sette","year":"2021","journal-title":"Cell"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.addr.2020.12.011","article-title":"COVID-19 vaccines: The status and perspectives in delivery points of view","volume":"170","author":"Chung","year":"2021","journal-title":"Adv Drug Delivery Rev"},{"key":"B9","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/j.cell.2022.01.015","article-title":"SARS-CoV-2 vaccination induces immunological T cell memory able to cross-recognize variants from Alpha to Omicron","volume":"185","author":"Tarke","year":"2022","journal-title":"Cell"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00459-7","article-title":"Characteristics of SARS-coV-2 and COVID-19","volume":"19","author":"Hu","year":"2021","journal-title":"Nat Rev Microbiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.virol.2020.08.011","article-title":"The novel coronavirus Disease-2019 (COVID-19): Mechanism of action, detection and recent therapeutic strategies","volume":"551","author":"Seyed Hosseini","year":"2020","journal-title":"Virology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e12998","DOI":"10.1111\/sji.12998","article-title":"Coronavirus disease 2019 (COVID-19): An overview of the immunopathology, serological diagnosis and management","volume":"93","author":"Anka","year":"2021","journal-title":"Scand J Immunol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3591","DOI":"10.3390\/cells10123591","article-title":"Cellular immunology and COVID-19","volume":"10","author":"Quinti","year":"2021","journal-title":"Cells"},{"key":"B14","unstructured":"Clinical management of COVID-19: living guideline\n          \n          \n          \n          2022"},{"key":"B15","unstructured":"COVID-19 epidemiological update\n          \n          \n          \n          2024"},{"key":"B16","unstructured":"COVID-19 epidemiological update\n          \n          \n          \n          2024"},{"key":"B17","unstructured":"COVID-19 epidemiological update\n          \n          \n          \n          2024"},{"key":"B18","unstructured":"SARS-CoV-2 variants of concern as of 28 March 2025"},{"key":"B19","doi-asserted-by":"publisher","first-page":"03946320231163681","DOI":"10.1177\/03946320231163681","article-title":"Patterns of cytokine and chemokine expression in peripheral blood of patients with COVID-19 associated with disease severity","volume":"37","author":"Trifonova","year":"2023","journal-title":"Int J Immunopathol Pharmacol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"10324","DOI":"10.1038\/s41598-024-61133-z","article-title":"Multi-cohort study on cytokine and chemokine profiles in the progression of COVID-19","volume":"14","author":"Huang","year":"2024","journal-title":"Sci Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"13054","DOI":"10.3390\/ijms241713054","article-title":"Lipid mediators and cytokines\/chemokines display differential profiles in severe versus mild\/moderate COVID-19 patients","volume":"24","author":"Ravindran","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.832394","article-title":"The role of cytokines and chemokines in severe acute respiratory syndrome coronavirus 2 infections","volume":"13","author":"Hsu","year":"2022","journal-title":"Front Immunol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1111\/all.14647","article-title":"Immunological imprint of COVID-19 on human peripheral blood leukocyte populations","volume":"76","author":"Kratzer","year":"2021","journal-title":"Allergy"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.66.12.1666","article-title":"Comparative evaluation of memory T cells in COVID-19 patients and the predictive role of CD4+CD8+ double positive T lymphocytes as a new marker","volume":"66","author":"Kalpakci","year":"2020","journal-title":"Rev Assoc M\u00e9dica Bras"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1172\/JCI137244","article-title":"Clinical and immunological features of severe and moderate coronavirus disease 2019","volume":"130","author":"Chen","year":"2020","journal-title":"J Clin Invest"},{"key":"B26","doi-asserted-by":"publisher","first-page":"758","DOI":"10.4081\/mrm.2021.758","article-title":"Differential alterations in peripheral lymphocyte subsets in COVID-19 patients: upregulation of double-positive and double-negative T cells","volume":"16","author":"Zahran","year":"2021","journal-title":"Multidiscip Respir Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27037","article-title":"Characterization of T lymphocytes in severe COVID-19 patients","volume":"93","author":"Fenoglio","year":"2021","journal-title":"J Med Virol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1186\/s12985-022-01926-8","article-title":"Characteristics of lymphocyte subset alterations in COVID-19 patients with different levels of disease severity","volume":"19","author":"Dai","year":"2022","journal-title":"Virol J"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1089\/vim.2021.0044","article-title":"Increased blood monocytic myeloid derived suppressor cells but low regulatory T lymphocytes in patients with mild COVID-19","volume":"34","author":"Jim\u00e9nez-Cortegana","year":"2021","journal-title":"Viral Immunol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1038\/349533a0","article-title":"Induction of CD4 and susceptibility to HIV-1 infection in human CD8+ T lymphocytes by human herpesvirus 6","volume":"349","author":"Lusso","year":"1991","journal-title":"Nature"},{"key":"B31","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3390\/v14010090","article-title":"A population of CD4+CD8+ Double-positive T cells associated with risk of plasma leakage in dengue viral infection","volume":"14","author":"Yu","year":"2022","journal-title":"Viruses"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.3390\/v14102243","article-title":"Increased CD4+CD8+ Double positive T cells during hantaan virus infection","volume":"14","author":"Zhang","year":"2022","journal-title":"Viruses"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020145","article-title":"Distinct CD4+ CD8+ double-positive T cells in the blood and liver of patients during chronic hepatitis B and C","volume":"6","author":"Nascimbeni","year":"2011","journal-title":"PloS One"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-018-0001-y","article-title":"The full spectrum of human naive T cells","volume":"18","author":"van den Broek","year":"2018","journal-title":"Nat Rev Immunol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"PA304","DOI":"10.1183\/13993003.congress-2024.PA304","article-title":"The role of peripheral blood CD4+CD45RA+ T cells and CD4+CD45RO+ T cells in evaluation of COVID-19 patients","volume":"64","author":"Su","year":"2024","journal-title":"Eur Respir J"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa248","article-title":"Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in wuhan, China","volume":"71","author":"Qin","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa664","article-title":"Evaluating immune dysregulation in patients with COVID-19 requires a more accurate definition of the CD45RA+ T-cell phenotype","volume":"71","author":"Poloni","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1387975","article-title":"Regulation of Treg cells by cytokine signaling and co-stimulatory molecules","volume":"15","author":"Zong","year":"2024","journal-title":"Front Immunol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.3390\/ijms24021527","article-title":"Human regulatory T cells: understanding the role of tregs in select autoimmune skin diseases and post-transplant nonmelanoma skin cancers","volume":"24","author":"Oparaugo","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2006.10.002","article-title":"Cell-surface IL-7 receptor expression facilitates the purification of FOXP3+ regulatory T cells","volume":"27","author":"Banham","year":"2006","journal-title":"Trends Immunol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2020.08.006","article-title":"Characteristics of immune cells and cytokines in patients with coronavirus disease 2019 in Guangzhou, China","volume":"81","author":"Chen","year":"2020","journal-title":"Hum Immunol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2111315118","article-title":"Profound Treg perturbations correlate with COVID-19 severity","volume":"118","author":"Galv\u00e1n-Pe\u00f1a","year":"2021","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B43","doi-asserted-by":"publisher","first-page":"3434","DOI":"10.1038\/s41467-020-17292-4","article-title":"Marked T cell activation, senescence, exhaustion and skewing towards TH17 in patients with COVID-19 pneumonia","volume":"11","author":"De Biasi","year":"2020","journal-title":"Nat Commun"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.3390\/v14081688","article-title":"Regulatory T cells decreased during recovery from mild COVID-19","volume":"14","author":"Seepathomnarong","year":"2022","journal-title":"Viruses"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1159\/000514202","article-title":"Dynamic changes of lymphocyte subsets in the course of COVID-19","volume":"182","author":"Rezaei","year":"2021","journal-title":"Int Arch Allergy Immunol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s12288-022-01558-6","article-title":"Role of T lymphocyte activation profile in predicting SARS-coV-2 severity: experience from tertiary care centre of north India","volume":"39","author":"Gupta","year":"2023","journal-title":"Indian J Hematol Blood Transfus"},{"key":"B47","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1038\/s41392-020-00263-y","article-title":"Adaptive immune responses to SARS-CoV-2 infection in severe versus mild individuals","volume":"5","author":"Zhang","year":"2020","journal-title":"Signal Transduct Target Ther"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1038\/s41423-020-0447-2","article-title":"High-dimensional immune profiling by mass cytometry revealed immunosuppression and dysfunction of immunity in COVID-19 patients","volume":"17","author":"Wang","year":"2020","journal-title":"Cell Mol Immunol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"11759","DOI":"10.3390\/ijms252111759","article-title":"T regulatory cell subsets do not restore for one year after acute COVID-19","volume":"25","author":"Aquino","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B50","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s40139-021-00226-0","article-title":"Chemokine-based therapeutics for the treatment of inflammatory and fibrotic convergent pathways in COVID-19","volume":"9","author":"Julian","year":"2021","journal-title":"Curr Pathobiol Rep"},{"key":"B51","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1002\/JLB.3COVA0820-410RRR","article-title":"Cytokine release syndrome in COVID-19: Innate immune, vascular, and platelet pathogenic factors differ in severity of disease and sex","volume":"109","author":"Petrey","year":"2021","journal-title":"J Leukoc Biol"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2026131","article-title":"Cytokine storm","volume":"383","author":"Fajgenbaum","year":"2020","journal-title":"N Engl J Med"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01708\/full","article-title":"Cytokine storm in COVID-19: the current evidence and treatment strategies","volume":"11","author":"Tang","year":"2020","journal-title":"Front Immunol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14970","article-title":"Effect of IL-6, IL-8\/CXCL8, IP-10\/CXCL 10 levels on the severity in COVID 19 infection","volume":"75","author":"Kesmez Can","year":"2021","journal-title":"Int J Clin Pract"},{"key":"B55","doi-asserted-by":"publisher","first-page":"156653","DOI":"10.1016\/j.cyto.2024.156653","article-title":"Cytokine and chemokine profiles in the sera of COVID-19 patients with different stages of severity","volume":"180","author":"Bourhis","year":"2024","journal-title":"Cytokine"},{"key":"B56","doi-asserted-by":"publisher","first-page":"2451145","DOI":"10.1002\/eji.202451145","article-title":"Immune signature of patients with cardiovascular disease predicts increased risk for a severe course of COVID-19","volume":"54","author":"G\u00fcnter","year":"2024","journal-title":"Eur J Immunol"},{"key":"B57","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jaci.2020.04.027","article-title":"Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19","volume":"146","author":"Yang","year":"2020","journal-title":"J Allergy Clin Immunol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.ijid.2020.02.014","article-title":"A unique immune signature of serum cytokine and chemokine dynamics in patients with Zika virus infection from a tropical region in Southern Mexico","volume":"94","author":"Zu\u00f1iga","year":"2020","journal-title":"Int J Infect Dis IJID Off Publ Int Soc Infect Dis"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200407-857OC","article-title":"Characterization of cytokine\/chemokine profiles of severe acute respiratory syndrome","volume":"171","author":"Jiang","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"B60","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1111\/j.1365-2249.2004.02415.x","article-title":"Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome","volume":"136","author":"Wong","year":"2004","journal-title":"Clin Exp Immunol"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa326","article-title":"Elevated CXCL10 serum levels in measles virus primary infection and reinfection correlate with the serological stage and hospitalization status","volume":"222","author":"Semmler","year":"2020","journal-title":"J Infect Dis"},{"key":"B62","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/j.cell.2020.09.038","article-title":"Antigen-specific adaptive immunity to SARS-coV-2 in acute COVID-19 and associations with age and disease severity","volume":"183","author":"Rydyznski Moderbacher","year":"2020","journal-title":"Cell"},{"key":"B63","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1186\/s10020-021-00390-4","article-title":"CXCL10 levels at hospital admission predict COVID-19 outcome: hierarchical assessment of 53 putative inflammatory biomarkers in an observational study","volume":"27","author":"Lor\u00e8","year":"2021","journal-title":"Mol Med Camb Mass"},{"key":"B64","doi-asserted-by":"publisher","first-page":"4830","DOI":"10.3390\/ijms23094830","article-title":"Cytokines from bench to bedside: A retrospective study identifies a definite panel of biomarkers to early assess the risk of negative outcome in COVID-19 patients","volume":"23","author":"Fabris","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1377014","article-title":"High interleukin-6 levels induced by COVID-19 pneumonia correlate with increased circulating follicular helper T cell frequency and strong neutralization antibody response in the acute phase of Omicron breakthrough infection","volume":"15","author":"Kawasuji","year":"2024","journal-title":"Front Immunol"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.72.8.4410-4415.2004","article-title":"Analysis of serum cytokines in patients with severe acute respiratory syndrome","volume":"72","author":"Zhang","year":"2004","journal-title":"Infect Immun"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1016\/j.virusres.2007.02.014","article-title":"Human immunopathogenesis of severe acute respiratory syndrome (SARS)","volume":"133","author":"Cameron","year":"2008","journal-title":"Virus Res"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2016.31.11.1717","article-title":"Clinical progression and cytokine profiles of middle east respiratory syndrome coronavirus infection","volume":"31","author":"Kim","year":"2016","journal-title":"J Korean Med Sci"},{"key":"B69","doi-asserted-by":"publisher","first-page":"25359","DOI":"10.1038\/srep25359","article-title":"Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity","volume":"6","author":"Min","year":"2016","journal-title":"Sci Rep"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy595","article-title":"Immune responses to middle east respiratory syndrome coronavirus during the acute and convalescent phases of human infection","volume":"68","author":"Shin","year":"2019","journal-title":"Clin Infect Dis Off Publ Infect Dis Soc Am"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1613629\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T05:30:31Z","timestamp":1758519031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1613629\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":70,"alternative-id":["10.3389\/fimmu.2025.1613629"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1613629","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,22]]},"article-number":"1613629"}}