{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:08:40Z","timestamp":1791230920080,"version":"4.1.0"},"reference-count":60,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Objective: The purpose of this study is to study cytokine indicators for the identification of severe fever with thrombocytopenia syndrome (SFTS) severity. Methods: We searched the literature in PubMed, Embase, and Web of Science published before 7 April 2026. The main results are presented as forest plots. Subgroup analyses, sensitivity analyses, and publication bias were also performed. Results: A total of 22 articles were eventually included in our study. Our findings demonstrate that circulating concentrations of Interleukin-6 (IL-6) (SMD = 2.02, 95% CI: 1.53\u20132.51, I2 = 95.2%), Interleukin-10 (IL-10) (SMD = 1.18, 95% CI: 0.92\u20131.44, I2 = 71.3%), Interleukin-8 (IL-8) (SMD = 0.91, 95% CI: 0.61\u20131.20, I2 = 69%), Tumor necrosis factor-alpha (TNF-\u03b1) (SMD = 0.70, 95% CI: 0.43\u20130.96, I2 = 64.6%), Interferon-gamma (IFN-\u03b3) (SMD = 1.32, 95% CI: 0.69\u20131.95, I2 = 89.1%), Interleukin-1 beta (IL-1\u03b2) (SMD = 1.78, 95% CI: 0.85\u20132.71, I2 = 94.8%), Monocyte chemoattractant protein-1 (MCP-1) (SMD = 1.15, 95% CI: 0.80\u20131.50, I2 = 46.1%), Interferon-alpha (IFN-\u03b1) (SMD = 1.53, 95% CI: 0.38\u20132.68, I2 = 89.6%), Granulocyte Colony-Stimulating Factor (G-CSF) (SMD = 1.79, 95% CI: 0.99\u20132.59, I2 = 68.1%) and Inducible protein 10 (IP-10) (SMD = 1.11, 95% CI: 0.60\u20131.62, I2 = 58.3%) are significantly elevated in patients with severe SFTS compared with those with mild disease, whereas Transforming Growth Factor-beta (TGF-\u03b2) (SMD = \u22120.51, 95% CI: \u22120.78\u2013\u22120.24, I2 = 6.0%) and RANTES (SMD = \u22120.10, 95% CI: \u22120.40\u20130.20, I2 = 0.0%) levels are reduced in the severe group. Conclusions: By analyzing the cytokine indicators of SFTS patients, we have found some indicators that are representative of SFTS severity. Our findings provide a clinically actionable basis for early severity prediction and further useful evidence for clinicians to manage severe patients efficiently.<\/jats:p>","DOI":"10.3390\/pathogens15070755","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:44:02Z","timestamp":1784544242000},"page":"755","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cytokine Indicators Associated with Disease Severity in Severe Fever with Thrombocytopenia Syndrome: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Yaqi","family":"Xie","sequence":"first","affiliation":[{"name":"Zhengzhou Center for Disease Control and Prevention, Zhengzhou 450001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanman","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, No. 100-Kexue Avenue, Zhengzhou 450001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6129-0310","authenticated-orcid":false,"given":"Shuaiyin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, No. 100-Kexue Avenue, Zhengzhou 450001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoqin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhengzhou Center for Disease Control and Prevention, Zhengzhou 450001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Xu, B., Liu, L., Huang, X., Ma, H., Zhang, Y., Du, Y., Wang, P., Tang, X., Wang, H., and Kang, K. 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