Cytokine profiles of mild-to-moderate SARS-CoV-2 infected and recovered pre-vaccinated individuals residing in Indonesia

Background. Accumulating evidence suggests the involvement of cytokine-mediated inflammation, in clinical severity and death related to SARS-CoV-2 infection, especially among pre -vaccinated individuals. An increased risk of death was also described among SARS-CoV-2 recovered individuals, which might be correlated with prolonged inflammatory responses. Despite being among the countries with the highest cumulative deaths due to COVID-19, evidence regarding cytokine profiles among SARS-CoV-2 infected and recovered pre -vaccinated individuals in Indonesia is scarce. Thus, this study aimed to describe the cytokines profiles of pre -vaccinated individuals residing in Indonesia, with mild -to -moderate SARS-CoV-2 infection and those who recovered. Methods. Sixty-one sera from 24 hospitalized patients with mild -to -moderate SARSCoV-2 infection, 24 individuals recovered from asymptomatic -to -moderate SARSCoV-2 infection, and 13 healthy controls unexposed to SARS-CoV-2 were used in this study. Quantification of serum cytokine levels, including IL -6, IL -8, IP-10, TNF-alpha, CCL-2, CCL-3, CCL-4, and CXCL-13, was performed using a Luminex multi-analyteprofiling (xMAP)-based assay. Results. The levels of IL -8 along with CCL-2 and CCL-4, were significantly higher (p <= 0.01) in hospitalized patients with mild -to -moderate SARS-CoV-2 infection and recovered individuals compared to healthy controls. However, no significant difference was observed in these cytokine levels between infected and recovered individuals. On the other hand, there were no significant differences in several other cytokine levels, including IL -6, IL -10, TNF-alpha, CCL-3, and CXCL-13, among all groups. Conclusion. IL -8, CCL-2, and CCL-4 were significantly elevated in pre -vaccinated Indonesian individuals with mild -to -moderate SARS-CoV-2 infection and those who recovered. The cytokine profiles described in this study might indicate inflammatory responses not only among SARS-CoV-2 infected, but also recovered individuals.