29 October 2021

Similarities and differences between 'cytokine storms’ in acute dengue and COVID-19

Dayarathna S, Jeewandara C, Gomes L et al. M, Stollenwek N. Similarities and differences between the ‘cytokine storms’ in acute dengue and COVID-19. Nature Sci Rep. 2020;10:19839.


An altered immune response to invading virus in which the body produces very high levels of inflammatory cytokines – the ‘cytokine storm’ – can lead to severe disease complications.

the ‘cytokine storm’ can lead to severe disease complications

Dayarathna et al. compared the cytokine and chemokine responses in COVID-19 and acute dengue patients, using these results to evaluate predictive values of specific cytokines in early acute dengue to determine subsequent disease severity.

In early disease, significantly higher levels of interleukin (IL)-6, IL-10 and macrophage inflammatory protein 3α were seen in patients who subsequently developed COVID-19 severe pneumonia or dengue haemorrhagic fever (DHF) compared with those who developed mild illness.

In patients who went on to develop severe COVID-19, these markers increased most significantly between timepoint A (5–9 days) and B (10–21 days).

Assessment of the predictive value of key cytokines in dengue revealed that, in early illness, IL-10 was the only key cytokine significantly increased in those who subsequently developed DHF, compared with those who developed dengue fever (DF). However, in this small study, the area under the curve value was insufficient to support the use of IL-10 alone as a predictive marker for DHF over DF.


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