Crimean-Congo Hemorrhagic Fever (CCHF) may present with a mild clinical course or else exhibit a severe profile with potentially fatal hemorrhaging. The pathogenesis of the disease has not yet been well described. Cytokines have recently been investigated in order to explain the pathogenesis. The latest reports show that adipokines are powerful inflammation modulators. This study investigated the effect of adipokines (resistin, leptin, and adiponectin) and ghrelin on disease severity in CCHF patients by testing their serum levels. This retrospective study was conducted with patients with CCHF hospitalized at the Karadeniz Technical University, Medical Faculty in Turkey. Patients were divided into severe and non-severe groups. Serum adipokine levels of patients with CCHF were measured using enzyme-linked immunosorbent assay (ELISA). Fifty-three patients with confirmed CCHF were investigated. Twenty-five (47.2%) of these patients constituted the severe group. Serum resistin levels in the severe and non-severe groups were 108.9 +/- 24.7ng/ml and 77.5 +/- 27.7ng/ml (P<0.001), leptin levels 15.5 +/- 9.8 and 11.2 +/- 5.1ng/ml (P=0.074), adiponectin levels 26.8 +/- 18.9 and 27.4 +/- 16.3ng/ml (P=0.903) and ghrelin levels 57.1 +/- 48.7 and 200.9 +/- 182.7ng/ml (P=0.001), all respectively. This study confirms that significant changes in serum levels of resistin and ghrelin take place in severe CCHF. J. Med. Virol. 87:310-314, 2015. (c) 2014 Wiley Periodicals, Inc.