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Wasihun Hailemichael,1 Mulugeta Kiros,2 Yibeltal Akelew,3 Sisay Getu,4 Henok Andualem1 1Immunology and Molecular Biology, Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Medical Microbiology, Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Immunology and Molecular Biology, Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 4Hematology and Immuno-Hematology, Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Wasihun HailemichaelImmunology and Molecular Biology, Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaTel +251 946111414Email wasihunh383@gmail.comAbstract: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has rapidly spread across the world since its first emergence in China in late 2019. It is a major public health concern with no effective treatct 3ments. The immunopathology of SARS-CoV-2 is associated with an excessive inflammatory response. Macrophage activation syndrome (MAS) is also associated with the severity of the disease in SARS-CoV-2-infected patients. Neopterin is a macrophage activation marker produced by monocytes and macrophages upon activation by interferon-gamma (IFN-γ). Neopterin is a well-established marker in a variety of diseases, and recent evidence indicates that it could be helpful in early prediction of the severity of COVID-19 disease and serve as a prognostic marker. Here, we outline the role of macrophage activation syndrome in the pathogenesis of SARS-CoV-2 and suggest that neopterin could be used as a biomarker for progression of COVID-19.Keywords: neopterin, biomarker, MAS, SARS-CoV-2, COVID-19