Cell specific peripheral immune responses predict survival in critical COVID-19 patients.
Junedh M AmruteAlexandra M PerryGautam AnandCarlos CruchagaKarl G HockChristopher W FarnsworthGwendalyn J RandolphKory J LavineAshley L SteedPublished in: Nature communications (2022)
SARS-CoV-2 triggers a complex systemic immune response in circulating blood mononuclear cells. The relationship between immune cell activation of the peripheral compartment and survival in critical COVID-19 remains to be established. Here we use single-cell RNA sequencing and Cellular Indexing of Transcriptomes and Epitomes by sequence mapping to elucidate cell type specific transcriptional signatures that associate with and predict survival in critical COVID-19. Patients who survive infection display activation of antibody processing, early activation response, and cell cycle regulation pathways most prominent within B-, T-, and NK-cell subsets. We further leverage cell specific differential gene expression and machine learning to predict mortality using single cell transcriptomes. We identify interferon signaling and antigen presentation pathways within cDC2 cells, CD14 monocytes, and CD16 monocytes as predictors of mortality with 90% accuracy. Finally, we validate our findings in an independent transcriptomics dataset and provide a framework to elucidate mechanisms that promote survival in critically ill COVID-19 patients. Identifying prognostic indicators among critical COVID-19 patients holds tremendous value in risk stratification and clinical management.
Keyphrases
- single cell
- sars cov
- rna seq
- immune response
- cell cycle
- gene expression
- high throughput
- nk cells
- respiratory syndrome coronavirus
- dendritic cells
- induced apoptosis
- machine learning
- peripheral blood
- coronavirus disease
- free survival
- cell cycle arrest
- cardiovascular events
- type diabetes
- oxidative stress
- artificial intelligence
- stem cells
- dna methylation
- mesenchymal stem cells
- high resolution
- endoplasmic reticulum stress
- genome wide
- high density
- deep learning
- bone marrow
- chemotherapy induced