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A dynamic COVID-19 immune signature includes associations with poor prognosis #MMPMID32807934
Laing AG; Lorenc A; Del Molino Del Barrio I; Das A; Fish M; Monin L; Munoz-Ruiz M; McKenzie DR; Hayday TS; Francos-Quijorna I; Kamdar S; Joseph M; Davies D; Davis R; Jennings A; Zlatareva I; Vantourout P; Wu Y; Sofra V; Cano F; Greco M; Theodoridis E; Freedman JD; Gee S; Chan JNE; Ryan S; Bugallo-Blanco E; Peterson P; Kisand K; Haljasmagi L; Chadli L; Moingeon P; Martinez L; Merrick B; Bisnauthsing K; Brooks K; Ibrahim MAA; Mason J; Lopez Gomez F; Babalola K; Abdul-Jawad S; Cason J; Mant C; Seow J; Graham C; Doores KJ; Di Rosa F; Edgeworth J; Shankar-Hari M; Hayday AC
Nat Med 2020[Oct]; 26 (10): 1623-1635 PMID32807934show ga
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.