The catastrophic outbreak of coronavirus disease 2019 (COVID-19) is currently a public emergency . Adult-onset Still's disease (AOSD) is an autoinflammatory disease characterized by life-threatening complications . Systemic hyperinflammation and cytokine storm play a critical role in the pathogenesis of both COVID-19 and AOSD . We aimed to compare the similarities and differences focusing on ferritin and cytokine levels between severe COVID-19 and active AOSD . A literature search was performed using the databases PubMed, EMBASE, and Web of Science to collect the levels of cytokine including IL-1ß, IL-6, IL-18, TNF- & #945;, IL-10, and ferritin in severe COVID-19 patients . After extracting available data of indicators of interest, we acquired these statistics with a single-arm meta-analysis . Furthermore, a comparison was conducted between 52 patients with active AOSD in our center and severe COVID-19 patients from databases . The levels of IL-6 and IL-10 were higher in severe COVID-19 compared with those in active AOSD . There were no significant differences on the cytokine of IL-1ß and TNF- & #945; . Fold changes of IL-18 were defined as the mean expression level ratio of severe COVID-19 to healthy controls in the COVID-19 study and active AOSD to healthy controls in our study, individually . Although the fold change of IL-18 in patients with AOSD was significantly higher than patients with severe COVID-19 (fold change : 594.00 vs 2.17), there was no statistical comparability . In addition, the level of ferritin was higher in active AOSD in comparison with severe COVID-19 . Our findings suggest that severe COVID-19 and active AOSD have differences in cytokine panel and ferritin level, indicating the pathogenic role of ferritin in overwhelming inflammation . And it paves the way to make efficacy therapeutic strategy targeting the hyperinflammatory process in COVID-19 according to AOSD management, especially in severe COVID-19.