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Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm.

Authors
  • Mudd, Philip A1
  • Crawford, Jeremy Chase2
  • Turner, Jackson S3
  • Souquette, Aisha2
  • Reynolds, Daniel4
  • Bender, Diane5
  • Bosanquet, James P6
  • Anand, Nitin J6
  • Striker, David A6
  • Martin, R Scott6
  • Boon, Adrianus C M4
  • House, Stacey L7
  • Remy, Kenneth E4, 8, 9
  • Hotchkiss, Richard S4, 9, 10
  • Presti, Rachel M4
  • O'Halloran, Jane A4
  • Powderly, William G4
  • Thomas, Paul G11
  • Ellebedy, Ali H12, 4, 5
  • 1 Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA. [email protected] [email protected] [email protected]
  • 2 Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA.
  • 3 Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA.
  • 4 Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • 5 Bursky Center for Human Immunology and Immunotherapy Program, Washington University School of Medicine, Saint Louis, MO, USA.
  • 6 Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • 7 Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • 8 Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.
  • 9 Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA.
  • 10 Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
  • 11 Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA. [email protected] [email protected] [email protected]
  • 12 Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA. [email protected] [email protected] [email protected]
Type
Published Article
Journal
Science Advances
Publisher
American Association for the Advancement of Science (AAAS)
Publication Date
Dec 01, 2020
Volume
6
Issue
50
Identifiers
DOI: 10.1126/sciadv.abe3024
PMID: 33187979
Source
Medline
Language
English
License
Unknown

Abstract

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. Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).

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