Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm.
Philip A MuddJeremy Chase CrawfordJackson S TurnerAisha SouquetteDaniel ReynoldsDiane E BenderJames P BosanquetNitin J AnandDavid A StrikerR Scott MartinAdrianus C M BoonStacey L HouseKenneth E RemyRichard S HotchkissRachel M PrestiJane A O'HalloranWilliam G PowderlyPaul Glyndwr ThomasAli H EllebedyPublished in: Science advances (2020)
We pursued a study of immune responses in coronavirus disease 2019 (COVID-19) and influenza patients. Compared to patients with influenza, patients with COVID-19 exhibited largely equivalent lymphocyte counts, fewer monocytes, and lower surface human leukocyte antigen (HLA)-class II expression on selected monocyte populations. Furthermore, decreased HLA-DR on intermediate monocytes predicted severe COVID-19 disease. In contrast to prevailing assumptions, very few (7 of 168) patients with COVID-19 exhibited cytokine profiles indicative of cytokine storm syndrome. After controlling for multiple factors including age and sample time point, patients with COVID-19 exhibited lower cytokine levels than patients with influenza. Up-regulation of IL-6, G-CSF, IL-1RA, and MCP1 predicted death in patients with COVID-19 but were not statistically higher than patients with influenza. Single-cell transcriptional profiling revealed profound suppression of interferon signaling among patients with COVID-19. When considered across the spectrum of peripheral immune profiles, patients with COVID-19 are less inflamed than patients with influenza.
Keyphrases
- coronavirus disease
- single cell
- sars cov
- peripheral blood
- dendritic cells
- immune response
- endothelial cells
- end stage renal disease
- ejection fraction
- respiratory syndrome coronavirus
- magnetic resonance
- magnetic resonance imaging
- newly diagnosed
- poor prognosis
- chronic kidney disease
- oxidative stress
- peritoneal dialysis
- early onset
- case report
- patient reported outcomes
- ankylosing spondylitis
- intellectual disability
- cerebrospinal fluid