Differential cytokine and chemokine signatures in bronchoalveolar lavage and plasma predict clinical outcomes of COVID-19 patients hospitalized in intensive care unit

cytokines storm in COVID-19 patients and Predict Clinical Outcomes

This study explores the immune response dynamics in critically ill SARS-CoV-2 patients compared to non-SARS-CoV-2 ICU controls, focusing on localized and systemic inflammatory profiles to identify patterns linked to clinical outcomes. A cohort of ICU patients (37 SARS-CoV-2 positive, 17 controls) underwent bronchoalveolar lavage (BAL) and plasma analysis to assess inflammatory markers using a multiplex assay. SARS-CoV-2 patients showed distinct clinical and immunological features, including prolonged ICU stays and elevated markers of systemic inflammation. Cluster analysis revealed subgroup-specific immune signatures, with COVID-19 survivors demonstrating coordinated cytokine/chemokine interactions suggestive of adaptive immune regulation, while non-survivors exhibited dysregulated profiles indicative of maladaptive inflammation. The study underscores the spatial segregation of immune responses, with lung-specific inflammation in BAL contrasting with systemic profiles, highlighting the importance of tissue-targeted monitoring. These findings suggest that immune profiling could inform stratification for tailored immunomodulatory therapies, advancing precision approaches in critical care for severe SARS-CoV-2 infections.

PIRALLA Antonio;  GIORIA Sabrina;  GUERRINI Giuditta;  PETAZZONI Greta;  GUGLIELMO Guglielmo;  FERRARI Alessandro;  GIARDINA Federica;  BERGAMI Federica;  ORLANDO Anita;  MONGODI Silvia;  CAPRA MARZANI Federico;  DE AMICI Mara;  TESTA Giorgio;  CALZOLAI Luigi;  BALDANTI Fausto; 

2025-10-20

ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD

JRC143445

1096-0023 (online),   

https://www.sciencedirect.com/science/article/pii/S1043466625001899,    https://publications.jrc.ec.europa.eu/repository/handle/JRC143445,   

10.1016/j.cyto.2025.157042 (online),