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

Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm.
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DOI:
10.1126/sciadv.abe3024
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发表时间:
2020-12
期刊:
影响因子:
13.6
通讯作者:
Ellebedy AH
Ellebedy AH
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Mudd PA;Crawford JC;Turner JS;Souquette A;Reynolds D;Bender D;Bosanquet JP;Anand NJ;Striker DA;Martin RS;Boon ACM;House SL;Remy KE;Hotchkiss RS;Presti RM;O'Halloran JA;Powderly WG;Thomas PG;Ellebedy AH

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Immunologic evaluation shows that most COVID-19 patients exhibit targeted immunosuppression compared to patients with influenza. 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.
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