SynthesisThe Lancet. Respiratory medicine2020
Cytokine elevation in severe and critical COVID-19: a rapid systematic review, meta-analysis, and comparison with other inflammatory syndromes.
Synthesis in The Lancet. Respiratory medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 561 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
561 citing papers in PubMed, 2 syntheses or guidelines pooled it, 896 citations in OpenAlex.
- Benefits of melatonin on mortality in severe-to-critical COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.Clinics (Sao Paulo, Brazil) · 2025Pooled it
- Mesenchymal Stem Cells on Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Stem cell reviews and reports · 2024Pooled it
- Antiviral and immunomodulatory effect of zapnometinib in animal models and hospitalized COVID-19 patients.Frontiers in immunology · 2025Trial
- Pharmacodynamic, prognostic, and predictive biomarkers in severe and critical COVID-19 patients treated with sirukumab.Scientific reports · 2024Trial
- SARS-CoV-2 RNA and Nucleocapsid Antigen Are Blood Biomarkers Associated With Severe Disease Outcomes That Improve in Response to Remdesivir.The Journal of infectious diseases · 2024Trial
- Inflammatory and tissue injury marker dynamics in pediatric acute respiratory distress syndrome.The Journal of clinical investigation · 2024Trial
- Simvastatin in Critically Ill Patients with Covid-19.The New England journal of medicine · 2023Trial
- SARS-CoV-2-specific T cell therapy for severe COVID-19: a randomized phase 1/2 trial.Nature medicine · 2023Trial
- Trial
- Immunomodulation and endothelial barrier protection mediate the association between oral imatinib and mortality in hospitalised COVID-19 patients.The European respiratory journal · 2022Trial
- Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial.The Lancet. Respiratory medicine · 2022Trial
- Comparative proteomics of human naso-oropharyngeal swabs from COVID19 patients for identification of potential biomarker candidates.Biochemistry and biophysics reports · 2026Article
- Functional immune changes are conserved in COVID-19 and trauma patients receiving intensive care.Nature communications · 2026Article
- A portable nanobiosensor with machine learning: enabling multi-cytokines point-of-care testing and early identification of sepsis immunoparalysis.Journal of nanobiotechnology · 2026Article
- Expanding High-Fidelity Multiplexing in Ultrasensitive Single-Molecule Protein Detection via Proximity Barcoding.Angewandte Chemie (International ed. in English) · 2026Article
- Heparin-binding protein and Endothelin-1 in critical COVID-19.BMC anesthesiology · 2026Article
- Understanding the long-term neurological effects of SARS-CoV-2 infection.Nature reviews. Neurology · 2026Review
- Pathogen-specific immune responses might underlie divergent outcomes of coronavirus and influenza infection in the natural porcine host.Communications biology · 2026Article
- Interleukin-6 in Castleman disease subtypes: look to tissues, not just blood.Haematologica · 2026Article
- Renal Biomarkers of Injury as Early Predictors of COVID-19 Associated Acute Kidney Injury: A Prospective Observational Trial (BRICOAKI Study).Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
501 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 9 institutions in 1 country.
Funding
Abstract
The description of a so-called cytokine storm in patients with COVID-19 has prompted consideration of anti-cytokine therapies, particularly interleukin-6 antagonists. However, direct systematic comparisons of COVID-19 with other critical illnesses associated with elevated cytokine concentrations have not been reported. In this Rapid Review, we report the results of a systematic review and meta-analysis of COVID-19 studies published or posted as preprints between Nov 1, 2019, and April 14, 2020, in which interleukin-6 concentrations in patients with severe or critical disease were recorded. 25 COVID-19 studies (n=1245 patients) were ultimately included. Comparator groups included four trials each in sepsis (n=5320), cytokine release syndrome (n=72), and acute respiratory distress syndrome unrelated to COVID-19 (n=2767). In patients with severe or critical COVID-19, the pooled mean serum interleukin-6 concentration was 36·7 pg/mL (95% CI 21·6-62·3 pg/mL; I
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.