Excessive activation of the immune system by damage-associated molecular patterns (DAMPs) contributes to COVID-19 severity. Interferon-induced protein 35 (IFI35) is a DAMP-related interferon-stimulated gene recently proposed as a biomarker of hyperinflammation. We investigated the association between IFI35 serum levels, gene expression, and COVID-19 severity in 430 hospitalized patients (214 critical and 216 severe) and 112 convalescent controls. Serum IFI35 levels were quantified using ELISA, and IFI35 mRNA expression in PBMCs was assessed using quantitative PCR (qPCR). IFI35 levels were significantly higher in critically ill patients (median 1,003.6 pg/mL) than in severe cases (867.6 pg/mL; p = 0.001) and controls (798.3 pg/mL; p 1,475 pg/mL was associated with reduced survival in this cohort (p = 0.0062). These findings identify IFI35 as a promising prognostic biomarker associated with COVID-19 severity and adverse outcomes.
Freitas et al. (2026) studied this question.