A dynamic COVID-19 immune signature includes associations with poor prognosis
Top Cited Papers
- 30 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Nature Medicine
- Vol. 26 (10), 1623-+
- https://doi.org/10.1038/s41591-020-1038-6
Abstract
A common immune signature in the blood of patients with COVID-19, who are otherwise clinically heterogeneous, sheds light into the pathogenesis and clinical progression of the disease. Improved understanding and management of COVID-19, a potentially life-threatening disease, could greatly reduce the threat posed by its etiologic agent, SARS-CoV-2. Toward this end, we have identified a core peripheral blood immune signature across 63 hospital-treated patients with COVID-19 who were otherwise highly heterogeneous. The signature includes discrete changes in B and myelomonocytic cell composition, profoundly altered T cell phenotypes, selective cytokine/chemokine upregulation and SARS-CoV-2-specific antibodies. Some signature traits identify links with other settings of immunoprotection and immunopathology; others, including basophil and plasmacytoid dendritic cell depletion, correlate strongly with disease severity; while a third set of traits, including a triad of IP-10, interleukin-10 and interleukin-6, anticipate subsequent clinical progression. Hence, contingent upon independent validation in other COVID-19 cohorts, individual traits within this signature may collectively and individually guide treatment options; offer insights into COVID-19 pathogenesis; and aid early, risk-based patient stratification that is particularly beneficial in phasic diseases such as COVID-19.Funding Information
- Wellcome Trust (106292/Z/4/Z)
- National Institute for Academic Anaesthesia (WKR0-2018-0047)
This publication has 63 references indexed in Scilit:
- Complement System Part II: Role in ImmunityFrontiers in Immunology, 2015
- Dengue Virus Infection Induces Expansion of a CD14+CD16+ Monocyte Population that Stimulates Plasmablast DifferentiationCell Host & Microbe, 2014
- Human CD1c+ dendritic cells secrete high levels of IL-12 and potently prime cytotoxic T-cell responsesBlood, 2013
- Discrimination of agonist and antagonist forms of CXCL10 in biological samplesClinical and Experimental Immunology, 2011
- Diagnostic Importance of Relative Lymphopenia as a Marker of Swine Influenza (H1N1) in AdultsClinical Infectious Diseases, 2009
- Mast Cells and Basophils: A Potential Link in Promoting Angiogenesis during Allergic InflammationInternational Archives of Allergy and Immunology, 2009
- The skin homing receptor cutaneous leucocyte-associated antigen (CLA) is up-regulated byLeishmaniaantigens in T lymphocytes during active cutaneous leishmaniasisClinical and Experimental Immunology, 2009
- An interferon‐γ‐related cytokine storm in SARS patientsJournal of Medical Virology, 2004
- Cytomegalovirus Infection in Transplant Recipients Resolves When Circulating γδ T Lymphocytes Expand, Suggesting a Protective Antiviral RoleThe Journal of Infectious Diseases, 2001
- Severe Herpesvirus Infections in an Adolescent without Natural Killer CellsThe New England Journal of Medicine, 1989