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Article

Cytokine Dynamics in Severe COVID-19 vs. Influenza A Elderly Patients: A Prospective Comparative Study

by
Mihai Aronel Rus
1,
Adina Huțanu
2,3,*,
Daniel Corneliu Leucuța
4,
Violeta Tincuța Briciu
1,5,
Monica Iuliana Muntean
1,5,
Angela Ionică
5 and
Mihaela Sorina Lupșe
1,5
1
Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania
2
Department of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142 Targu Mures, Romania
3
Advanced Medical and Pharmaceutical Research Center, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540136 Targu Mures, Romania
4
Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Pasteur Street, no 6, 400349 Cluj-Napoca, Romania
5
Clinical Hospital for Infectious Diseases, Iuliu Moldovan Street, no 23, 400348 Cluj-Napoca, Romania
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2026, 27(3), 1463; https://doi.org/10.3390/ijms27031463
Submission received: 8 January 2026 / Revised: 24 January 2026 / Accepted: 29 January 2026 / Published: 1 February 2026
(This article belongs to the Special Issue Molecular Research and Insights into COVID-19: Third Edition)
Review Reports Versions Notes

Abstract

COVID-19 and influenza A (FluA) cause severe respiratory infections in elderly patients, with cytokine dysregulation playing a central role. Direct comparative data in older adults remains limited. We aimed to characterize cytokine dynamics and their prognostic value in hospitalized elderly patients with COVID-19 vs. FluA. We performed a prospective cohort study including adults ≥ 60 years hospitalized with respiratory failure due to COVID-19 or FluA between March 2023 and March 2024. Serum IL-1β, IL-6, IL-10, IL-17A, IL-34, MCP-1, and CXCL10 were measured on Day 1 and Day 5 of hospitalization using Luminex®. Cytokines and associations with non-invasive ventilation (NIV) were assessed by ROC analysis and multivariate logistic regression. 83 patients were included (39 COVID-19, median age 79 years; 44 FluA, median 77 years). At Day 1, COVID-19 exhibited significantly higher IL-6, IL-10, and CXCL10; FluA showed an attenuated cytokine response. At Day 5, cytokines declined in both groups. Baseline IL-6 independently predicted NIV (adjusted OR 3.02), whereas higher MCP-1 was associated with reduced NIV requirement. Early cytokine differences between COVID-19 and FluA are evident in elderly patients, but values converged by Day 5. IL-6 remains an informative early predictor of respiratory deterioration; MCP-1 may reflect a regulated innate response.
Keywords: COVID-19; influenza A; cytokines; Luminex COVID-19; influenza A; cytokines; Luminex

Share and Cite

MDPI and ACS Style

Rus, M.A.; Huțanu, A.; Leucuța, D.C.; Briciu, V.T.; Muntean, M.I.; Ionică, A.; Lupșe, M.S. Cytokine Dynamics in Severe COVID-19 vs. Influenza A Elderly Patients: A Prospective Comparative Study. Int. J. Mol. Sci. 2026, 27, 1463. https://doi.org/10.3390/ijms27031463

AMA Style

Rus MA, Huțanu A, Leucuța DC, Briciu VT, Muntean MI, Ionică A, Lupșe MS. Cytokine Dynamics in Severe COVID-19 vs. Influenza A Elderly Patients: A Prospective Comparative Study. International Journal of Molecular Sciences. 2026; 27(3):1463. https://doi.org/10.3390/ijms27031463

Chicago/Turabian Style

Rus, Mihai Aronel, Adina Huțanu, Daniel Corneliu Leucuța, Violeta Tincuța Briciu, Monica Iuliana Muntean, Angela Ionică, and Mihaela Sorina Lupșe. 2026. "Cytokine Dynamics in Severe COVID-19 vs. Influenza A Elderly Patients: A Prospective Comparative Study" International Journal of Molecular Sciences 27, no. 3: 1463. https://doi.org/10.3390/ijms27031463

APA Style

Rus, M. A., Huțanu, A., Leucuța, D. C., Briciu, V. T., Muntean, M. I., Ionică, A., & Lupșe, M. S. (2026). Cytokine Dynamics in Severe COVID-19 vs. Influenza A Elderly Patients: A Prospective Comparative Study. International Journal of Molecular Sciences, 27(3), 1463. https://doi.org/10.3390/ijms27031463

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