Cytokine profile as biomarker of COVID-19 and its correlation with liver function enzymes and other markers of inflammation


  • Gita Nepal Father Muller Medical College, Mangalore, Karnataka India
  • Maitreyee D. S. Father Muller Medical College, Mangalore, Karnataka India
  • Akshatha Rao Aroor Father Muller Medical College, Mangalore, Karnataka India
  • Shivashankara A. R. Father Muller Medical College, Mangalore, Karnataka India



Biomarker, COVID-19, cytokines, inflammation, interleukins


Introduction and Aim: Various hematological and biochemical parameters are assessed as biomarkers of COVID-19, caused by the SARS-CoV-2. In this study, efforts were made to identify the correlation of cytokines (IL-6, TNF-?, IL-1?, and IL-1?) with the liver function enzyme markers, LDH, CRP, Ferritin, and D-dimer. We also assessed the correlation of cytokines with severity of COVID-19.


Materials and Methods: We analyzed 53 serum samples of RT-PCR-positive patients admitted to the hospital. Cytokines (IL-6, TNF-?, IL-1?, and IL-1?) were analyzed with sandwich ELISA.  The levels of cytokines were compared between mild, moderate, and severe cases of COVID-19, and the correlation among cytokines, liver function marker enzymes, LDH, CRP, D-dimer, and ferritin were analyzed.


Results: Along with CRP, LDH and ferritin, IL-6 showed significant difference between mild, moderate, and severe COVID groups. significant correlation between IL-6 & LDH (p -.002), IL-6 & D-Dimer (p- .010), IL-6 & IL-1? (p- .027), IL-1? & D-Dimer (p- .010), IL-1? & LDH (p-.027), and IL-1? & TNF-? & (p-.000).


Conclusion: Cytokines especially IL-6 correlated with disease severity. Assaying the profile of cytokines could be of immense value in diagnosis, prognosis, and management of COVID-19.


Cai, Q., Huang, D., Yu, H., Zhu, Z., Xia, Z., Su, Y., et al., COVID-19: Abnormal liver function tests. J Hepatol. 2020 Sep 1; 73(3): 566-574.

Basu-Ray, I., Adeboye, A. S. M. Cardiac Manifestations Of Coronavirus (COVID-19). StatPearls. 2021 May 19;

Feng, G., Zheng, K. I., Yan, Q. Q., Rios, R. S., Targher, G., Byrne, C. D., et al., Covid-19 and liver dysfunction: Current insights and emergent therapeutic strategies. J Clin Transl Hepatol. 2020; 8(1): 18-24.

Dinarello, C. A. Biologic Basis for Interleukin-1 in Disease. Blood. 1996 Mar 15; 87(6): 2095-2147.

Ye, Q., Wang, B. M. J. The pathogenesis and treatment of the `Cytokine Storm’ in COVID-19. J Infect. 2020 Jun 1; 80(6): 607-613.

Giemza-Stok?osa, J., Islam, M.A.K.P. Hyperferritinaemia: an iron sword of autoimmunity. Curr Pharm Des. 2019; 25(27): 2909-2918.

Feldmann, M., Maini, R. N., Woody, J. N., Holgate, S. T., Winter, G., Rowland, M., et al., Trials of anti-tumour necrosis factor therapy for COVID-19 are urgently needed. Lancet. 2020; 395(10234): 1407-1409.

Chen, L.Y.C., Hoiland, R. L., Stukas, S., Wellington, C. L., Sekhon, M. S. Confronting the controversy: Interleukin-6 and the COVID-19 cytokine storm syndrome. Eur Respir J. 2020; 56(4).

Del Valle, D. M., Kim-Schulze, S., Huang, H. H., Beckmann, N. D., Nirenberg, S., Wang, B., et al., An inflammatory cytokine signature predicts COVID-19 severity and survival. Nat Med. 2020 Aug 24; 26(10): 1636-1643. Available from:

Zeng, Z., Yu, H., Chen, H., Qi, W., Chen, L., Chen, G., et al., Longitudinal changes of inflammatory parameters and their correlation with disease severity and outcomes in patients with COVID-19 from Wuhan, China. Crit Care. 2020; 24(1): 1-12.

Asghar, M. S., Kazmi, H.S.J., Khan, A. N., Akram, M., Hassan, M., Rasheed, U., et al., Poor Prognostic biochemical markers predicting fatalities caused by COVID-19: A retrospective observational study from a developing country. Cureus. 2(8): e9575. doi:10.7759/cureus.9575.

Chen, G., Wu, D., Guo, W., Cao, Y., Huang, D., Wang, H., et al., Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020 May 1; 130(5): 2620-2629.

Keddie, S., Ziff, O., Chou, M. K., Taylor, R. L., Heslegrave, A., Garr, E., et al.,Laboratory biomarkers associated with COVID-19 severity and management. Clin Immunol. 2020 Dec; 221: 108614. doi: 10.1016/j.clim.2020.108614.

Han, H., Ma, Q., Li, C., Liu, R., Zhao, L., Wang, W., et al., Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors. Emerg Microbes Infect. 2020; Jan; 9(1): 1123-1130.

Effenberger, M., Grander, C., Grabherr, F., Griesmacher, A., Ploner, T., Hartig, F., et al., Systemic inflammation as fuel for acute liver injury in COVID-19. Dig Liver Dis [Internet]. 2021; 53(2): 158-165.

Zhang, J., Hao, Y., Ou, W., Ming, F., Liang, G., Qian, Y., et al., Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: a cohort study. J Transl Med [Internet]. 2020 Dec 1 [cited 2021 Jul 29]; 18(1). Available from:




How to Cite

Nepal G, D. S. M, Aroor AR, A. R. S. Cytokine profile as biomarker of COVID-19 and its correlation with liver function enzymes and other markers of inflammation. Biomedicine [Internet]. 2021Dec.31 [cited 2022Jan.20];41(4):747-51. Available from:



Original Research Articles