pg. 1 Title: Correlation between Proinflammatory cytokines and severity of COVID-19 within Palestinian Population Authors:

COVID-19 was characterized by cytokine storm and endothelial dysfunction in severely ill patients. As the severity of the infection was corelated with ethnicity, this study aimed to assess the correlation of proinflammatory cytokine serum level and COVID-19 symptoms within the Palestinian population. In crosssectional study, serum samples of 27 non-hospitalized patients and 63 hospitalized patients SARS-CoV-2 infected patients, were tested for total antibodies, IL-6, TNF-α, IFN-γ and IL-1β using the ELISA test. Results showed that most common symptoms within patients were Joint pain, cough, and fever (73.3%, 69.7% and 50% respectively). Serum total antibodies (IGs) levels in non-hospitalized patients were higher than hospitalized patients ((44.7 COI and 9.2 COI). TNF-α and IL-6 were lower in non-hospitalized patients compared to hospitalized patients (48±17.9 pg/ml, 193.3±350.5 pg/ml respectively). On the other hand, IFN-γ, in nonhospitalized patients (1±2 IU/ml) was significantly higher than hospitalized patients (0.4±0.26 IU/ml). IL-1β was slightly lower in hospitalized patients (8.8±13.6 pg/ml ) compared to non-hospitalized patients (12.5±24.5 pg/ml). Common mild symptoms of COVID-10 were negatively associated with proinflammatory cytokines serum level. In conclusion as it with other populations worldwide, IL-6 and TNFα are playing a major role in the complications of SARS-CoV-2 infection. Monitoring the two cytokines is crucial for management and treatment of complicated consequence of COVID-19.