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Objective To analyze the predictive value of serum levels of procalcitonin (PCT) and cytokines on the prognosis of patients with COVID-19 at admission. Methods From November 2022 to February 2023, patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled. Chemiluminescence was used to detect serum PCT levels, and flow microsphere array was used to detect serum cytokines IL- 1P, IL -2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-a, TNF- P, IFN-y level. ICU admission, mechanical ventilation and in-hospital death were defined as poor prognosis. After excluding patients with bacterial infection, the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed. After excluding patients with bacterial infection, the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed. Results A total of 176 patients with complete data were included, including 134 in the PCT-normal group and 42 in the PCT-elevated group, with a median age of 71.50 years and 71.59% males. Patients in the PCT elevated-group had significantly higher rates of ICU admission (38.41% vs. 13.11%, P < 0.05), mechanical ventilation (76.92% vs. 24.59%, P < 0.001) and in-hospital mortality (38.46% vs. 6.56%, P < 0.001) were significantly higher than those in the PCT-normal group. Serum levels of cytokines IL-6 (7.40 pg/mL vs. 4.78 pg/mL, P = 0.033 4) and IL-8 (10.97 pg/mL vs. 5.92 pg/mL, P < 0.001) were significantly higher in patients with poor prognosis than in those with good prognosis. The area under the curve for PCT, IL-6, and IL-8 to predict poor prognosis in COVID-19 patients was 0.687, 0.660, and 0.746, respectively; sensitivity was 52.78%, 55.17%, and 72.41%, respectively; and specificity was 81.58%, 74.19%, and 74.19%, respectively, as calculated from the ROC curve. When PCT, IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients, the area under the curve is 0.764, the sensitivity is 70.00%, and the specificity is 80.00%. Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19. [ABSTRACT FROM AUTHOR]