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An abnormally strong proinflammatory response known as “cytokine storm” may play an important role in the pathophysiology of coronavirus disease 2019 (COVID-19), although cytokine storm remains ill defined.1 Sinha and colleagues2 reported that although IL-6 levels are elevated in severe COVID-19, they are lower than levels usually observed in (non–COVID-19) acute respiratory distress syndrome (ARDS). However, this comparison is limited by the use of different assays, which are not well standardized.3 We compared cytokine levels in critically ill patients with COVID-19 vs levels in patients with other critical illnesses.
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Corresponding Author: Peter Pickkers, MD, PhD, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands (firstname.lastname@example.org).
Accepted for Publication: August 20, 2020.
Published Online: September 3, 2020. doi:10.1001/jama.2020.17052
Author Contributions: Dr Kox had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Kox, Pickkers.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Kox, Waalders, Pickkers.
Critical revision of the manuscript for important intellectual content: Kooistra, Gerretsen, Pickkers.
Statistical analysis: Kox, Waalders.
Administrative, technical, or material support: Waalders, Kooistra, Pickkers.
Conflict of Interest Disclosures: None reported.
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