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An excessive inflammatory response to SARS-CoV-2 is thought to be a major cause of disease severity and mortality in patients with COVID-19. Longitudinal analysis of cytokine release can expand our understanding of the initial stages of disease development and help to identify early markers serving as predictors of disease severity. In this study, we performed a comprehensive analysis of 46 cytokines (including chemokines and growth factors) in the peripheral blood of a large cohort of COVID-19 patients (n=444). The patients were classified into five severity groups. Longitudinal analysis of all patients revealed two groups of cytokines, characterizing the “early” and “late” stages of the disease course and the switch between type 1 and type 2 immunity. We found significantly increased levels of cytokines associated with different severities of COVID-19, and levels of some cytokines were significantly higher during the first three days from symptom onset (DfSO) in patients who eventually required intensive care unit (ICU) therapy. Additionally, we identified nine cytokines, TNF-α, IL-10, MIG, IL-6, IP-10, M-CSF, G-CSF, GM-CSF, and IFN-α2, that can be used as good predictors of ICU requirement at 4-6 DfSO.

The ongoing worldwide COVID-19 pandemic caused by SARS-CoV-2 has had serious impacts on not only the health care system but also all sectors of the economy. Thanks to the adoption of various epidemiological measures, a significant reduction in new cases of infection has been achieved. However, there are still “hotspots”, such as healthcare settings focused on treating patients with COVID-19, which are characterized by the risk of nosocomial transmission among health care workers, patients, and visitors. The proper monitoring and timely detection of pathogens in a hospital environment will help prevent further spread of coronavirus infection. In this study, we collected samples from the air and surface swabs at the First Moscow Infectious Diseases Hospital to study the spread of the SARS-CoV-2 in various hospital locations. More than 130 aerosol and surface samples were collected and analysed by RT-PCR. We detected viral contamination of the air in the intensive care unit (ICU) but not in the respiratory infection department where less severe patients are treated. The concentration of SARS-CoV-2 RNA was low, consisting of less than one copy per litre of air. The contact surfaces in both departments were contaminated with SARS-CoV-2. Considering the possible transmission of SARS-CoV-2 through fomites, these results indicate the need to strictly follow personal hygiene rules as well as wear personal protective equipment to prevent disease spread.