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1000
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Abstract/Summary
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<jats:sec><jats:title>Background</jats:title><jats:p>Hyperinflammation with dysregulated production of galectins and cytokines may develop in COVID-19 or adult-onset Still’s disease (AOSD). Given the similar clinical features in both diseases, it is necessary to identify biomarkers that can differentiate COVID-19 from AOSD. However, the related data remain scarce currently.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In this cross-sectional study, plasma levels of galectin-3, galectin-9, and soluble TIM-3 (sTIM-3) were determined by ELISA in 55 COVID-19 patients (31 non-severe and 24 severe), 23 active AOSD patients, and 31 healthy controls (HC). The seropositivity for SARS-CoV-2 was examined using an immunochromatographic assay, and cytokine profiles were determined with the MULTIPLEX platform.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Significantly higher levels of galectin-3, galectin-9, IL-1β, IL-1Ra, IL-10, IFN-α2, IL-6, IL-18, and TNF-α were observed in severe COVID-19 and active AOSD patients compared with HC (all p&lt;0.001). AOSD, but not COVID-19, showed significantly higher IFN-γ and IL-17A compared with HC (both p&lt;0.01). Moreover, active AOSD patients had 68-fold higher IL-18 levels and 5-fold higher ferritin levels than severe COVID-19 patients (both p&lt;0.001). IL-18 levels at the cut-off value 190.5pg/mL had the highest discriminative power for active AOSD and severe COVID-19, with AUC 0.948, sensitivity 91.3%, specificity 95.8%, and accuracy of 91.5% (p&lt;0.005). Multivariate regression analysis revealed IL-18 as a significant predictor of active AOSD (p&lt;0.05).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Active AOSD patients share features of hyperinflammation and cytokine storm with severe COVID-19 patients but possess a distinct cytokine profile, including elevated IL-18, IL-6, IFN-γ, and IL-17A. IL-18 is a potential discriminator between AOSD and COVID-19 and may significantly predict active AOSD.</jats:p></jats:sec>
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