{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T19:46:47Z","timestamp":1770061607689,"version":"3.49.0"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Cluj-Napoca","award":["771\/61\/11.01.2023"],"award-info":[{"award-number":["771\/61\/11.01.2023"]}]},{"name":"\u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Cluj-Napoca","award":["647\/54\/11.01.2024"],"award-info":[{"award-number":["647\/54\/11.01.2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>COVID-19 and influenza A (FluA) cause severe respiratory infections in elderly patients, with cytokine dysregulation playing a central role. Direct comparative data in older adults remains limited. We aimed to characterize cytokine dynamics and their prognostic value in hospitalized elderly patients with COVID-19 vs. FluA. We performed a prospective cohort study including adults \u2265 60 years hospitalized with respiratory failure due to COVID-19 or FluA between March 2023 and March 2024. Serum IL-1\u03b2, IL-6, IL-10, IL-17A, IL-34, MCP-1, and CXCL10 were measured on Day 1 and Day 5 of hospitalization using Luminex\u00ae. Cytokines and associations with non-invasive ventilation (NIV) were assessed by ROC analysis and multivariate logistic regression. 83 patients were included (39 COVID-19, median age 79 years; 44 FluA, median 77 years). At Day 1, COVID-19 exhibited significantly higher IL-6, IL-10, and CXCL10; FluA showed an attenuated cytokine response. At Day 5, cytokines declined in both groups. Baseline IL-6 independently predicted NIV (adjusted OR 3.02), whereas higher MCP-1 was associated with reduced NIV requirement. Early cytokine differences between COVID-19 and FluA are evident in elderly patients, but values converged by Day 5. IL-6 remains an informative early predictor of respiratory deterioration; MCP-1 may reflect a regulated innate response.<\/jats:p>","DOI":"10.3390\/ijms27031463","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:00:33Z","timestamp":1770022833000},"page":"1463","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cytokine Dynamics in Severe COVID-19 vs. Influenza A Elderly Patients: A Prospective Comparative Study"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8531-3146","authenticated-orcid":false,"given":"Mihai Aronel","family":"Rus","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-1594","authenticated-orcid":false,"given":"Adina","family":"Hu\u021banu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 540142 Targu Mures, Romania"},{"name":"Advanced Medical and Pharmaceutical Research Center, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 540136 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4218-8622","authenticated-orcid":false,"given":"Daniel Corneliu","family":"Leucu\u021ba","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Pasteur Street, no 6, 400349 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violeta Tincu\u021ba","family":"Briciu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"},{"name":"Clinical Hospital for Infectious Diseases, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1288-3918","authenticated-orcid":false,"given":"Monica Iuliana","family":"Muntean","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"},{"name":"Clinical Hospital for Infectious Diseases, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1438-2498","authenticated-orcid":false,"given":"Angela","family":"Ionic\u0103","sequence":"additional","affiliation":[{"name":"Clinical Hospital for Infectious Diseases, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela Sorina","family":"Lup\u0219e","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"},{"name":"Clinical Hospital for Infectious Diseases, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e70015","DOI":"10.1111\/irv.70015","article-title":"Trends in Hospitalisations for Vaccine Preventable Respiratory Infections Following Emergency Department Presentations in New South Wales, Australia, 2012\u20132022","volume":"18","author":"Hossain","year":"2024","journal-title":"Influenza Other Respir. 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