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

Philip A Mudd, Jeremy Chase Crawford, Jackson S Turner, Aisha Souquette, Daniel Reynolds, Diane Bender, James P Bosanquet, Nitin J Anand, David A Striker, R Scott Martin, Adrianus C M Boon, Stacey L House (+7 others)
2020 Science Advances  
We pursued a study of immune responses in COVID-19 and influenza cohorts. Compared to influenza patients, COVID-19 patients exhibited largely equivalent lymphocyte counts, fewer monocytes, and lower surface HLA-class II expression on select monocyte populations. Furthermore, decreased HLA-DR on intermediate monocytes was a significant predictor of COVID-19 disease severity. In contrast to prevailing assumptions about COVID-19 disease immunopathology, very few (7 of 168) COVID-19 patients
more » ... ed cytokine profiles indicative of Cytokine Storm Syndrome. After controlling for key confounding factors such as age and sample time point, COVID-19 patients exhibited lower cytokine levels than influenza patients. Up-regulation of IL-6, GCSF, IL-1RA, and MCP1 predicted death from acute respiratory failure among COVID-19 patients but were not statistically higher than influenza patients. Single-cell transcriptional profiling was concordant with profound suppression in interferon signaling among COVID-19 patients. When considered across the spectrum of peripheral immune profiles, COVID-19 patients are less inflamed than influenza patients.
doi:10.1126/sciadv.abe3024 pmid:33187979 pmcid:PMC7725462 fatcat:hil35obc2re47esfn4gfjlz7yy