{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:31:19Z","timestamp":1790753479617,"version":"4.1.0"},"reference-count":46,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>(1) Background\/Aim: People infected with SARS-CoV-2 may develop COVID-19 in a wide range of clinical severity. Pulmonary fibrosis is characterized by several grades of chronic inflammation and collagen deposition in the interalveolar space. SARS-CoV-2 infection has been demonstrated to cause lung fibrosis without a currently elucidated mechanism. Some studies emphasize the role of proinflammatory cytokines. This research studies the correlation of the released cytokines with mortality or lung injury in COVID-19 patients. (2) Methods: Electronic medical record data from 40 patients diagnosed with COVID-19 in the COVID-19 Department, Galilee Medical Center, Nahariya, Israel, were collected. Epidemiological, clinical, laboratory, and imaging variables were analyzed. The cytokine levels were measured upon admission and discharge. A correlation between cytokine levels and severity and mortality or lung involvement was undertaken. (3) Results: IFN-gamma and IL-10 are the most powerful risk factors for mortality in the COVID-19 patient groups in a multivariate analysis. However, in a univariate analysis, TGF-\u03b2, CXCL-10, IFN gamma, and IL-7 affected mortality in COVID-19 patients. MMP-7 was significantly correlated with a cytokine storm and a high 4-C (severity) score in COVID-19 patients. MMP-7, TGF-\u03b2, IL-10, IL-7, TNF-\u03b1, and IL-6 were correlated with high lung involvement in COVID-19 patients. Serum concentrations of IGF-1 were significantly increased upon discharge, but MMP-7 was decreased. (4) Conclusions: Proinflammatory cytokines predict clinical severity, lung fibrosis, and mortality in COVID-19 patients. High concentrations of TGF-\u03b2, CXCL-10, IL-10, IL-6, and TNF-\u03b1 are correlated to severity and lung injury. However, certain cytokines have protective effects and higher levels of these cytokines increase survival levels and lower lung damage. High levels of INF-\u03b3, IL-7, MMP-7, and IGF-1 have protection probabilities against lung injury and severity.<\/jats:p>","DOI":"10.3390\/cimb44100323","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T21:07:11Z","timestamp":1665436031000},"page":"4735-4747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Cytokine Patterns in COVID-19 Patients: Which Cytokines Predict Mortality and Which Protect Against?"],"prefix":"10.3390","volume":"44","author":[{"given":"Maamoun","family":"Basheer","sequence":"first","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"},{"name":"The Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Saad","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"},{"name":"The Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majd","family":"Kananeh","sequence":"additional","affiliation":[{"name":"Internal Medicine Department C, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layyous","family":"Asad","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Khayat","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anan","family":"Badarne","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaki","family":"Abdo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Arraf","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris","family":"Milhem","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Bassal","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Boulos","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2279-6041","authenticated-orcid":false,"given":"Nimer","family":"Assy","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Galilee Medical Center, Nahariya 221001, Israel"},{"name":"The Azrieli Faculty of Medicine, Bar-Ilan University, Safad 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1001\/jama.2020.6775","article-title":"Presenting characteristics, comorbidities and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area","volume":"323","author":"Richardson","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9490","DOI":"10.1073\/pnas.2004168117","article-title":"Effectiveness of convalescent plasma therapy in severe COVID-19 patients","volume":"117","author":"Duan","year":"2020","journal-title":"Proc. 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