Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm
Open Access
- 11 December 2020
- journal article
- research article
- Published by American Association for the Advancement of Science (AAAS) in Science Advances
- Vol. 6 (50), eabe3024
- https://doi.org/10.1126/sciadv.abe3024
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.Funding Information
- National Institute of Allergy and Infectious Diseases (AI139813)
- National Institute of Allergy and Infectious Diseases (AI141990)
- National Institute of Allergy and Infectious Diseases (contract 75N93019C00051)
- National Institute of Allergy and Infectious Diseases (contract HHSN272201400008C)
- National Institute of Allergy and Infectious Diseases (AI121832)
- National Institute of Allergy and Infectious Diseases (contract HHSN272201400006C P)
- National Center for Advancing Translational Sciences (UL1TR002345)
- Foundation for Barnes-Jewish Hospital
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