The Cytokine Profile in Sudanese Patients Infected with COVID-19 in Kassala State, Eastern Sudan

Abstract

Background: Research is ongoing to better understand the immune response and the role of cytokines in COVID-19's pathogenicity and clinical heterogeneity. Objectives: This study aimed to assess the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-17, IL-6, IL-10, and IL-4 in the blood of patients infected with severe acute respiratory syndrome (SARS)-CoV-2 in Kassala State, Eastern Sudan, compared to healthy individuals residing in the same state. Methods: This case-control study was conducted on 90 adult patients with COVID-19 infection at Kassala Teaching Hospital (KTH), confirmed by RT-PCR, and compared to 90 age- and sex-matched healthy subjects as controls. Serum samples were collected and analyzed for cytokine levels using the enzyme-linked immunosorbent assay (ELISA). Results: The levels of TNF-α, IL-17, and IL-10 in patients were significantly higher (P = 0.021, 0.000, and 0.015, respectively) than those in the control group. Conversely, the IL-4 levels were significantly lower (P = 0.000) in patients than in controls. A comparison between mild, moderate, and severe groups showed that the levels of TNF-α and IL-10 were higher in the severe group than in the mild and moderate groups, whereas the levels of IL-4 decreased with increasing disease severity without reaching significant differences. Tumor necrosis factor-α, IL-17, and IL-4 could predict the disease severity of 2019-nCoV infections according to the area under the curve (AUC) of the receiver operating curve (ROC). Conclusions: Our findings suggest that TNF-α, IL-17, IL-10, and IL-4 can serve as indicators and reliable predictors of severe illness in Sudanese patients with COVID-19.