"What have we learnt from this report, and what still needs to be done? It is clear from this and other studies that the immune response in hospitalized patients with severe COVID-19 is characterized by lymphopenia and the expression of molecules associated with ongoing inflammation8, whereas these same molecules are expressed at a lower level in people with mild or moderate disease. Differences in immune responses between the different categories of disease severity are even more evident when people with very mild or subclinical disease are included in the analyses4.
For results to be clinically useful, it will be necessary to define a limited number of biomarkers that can be both readily measured and used to predict disease outcomes. This could be difficult, because many of the changes in cytokine expression observed in studies such as that of Lucas and colleagues are useful for population-level analyses but less so for predicting outcomes in individual patients. Levels of specific cytokines vary substantially between people, making it hard to benchmark a level of cytokine expression that constitutes a sign of abnormality. Therefore, groups of cytokines, each with different degrees of inter-individual variability, must be measured to identify useful alterations." [1]
1. Nature 584, 345-346 (2020)
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