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Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm.
Mudd, Philip A; Crawford, Jeremy Chase; Turner, Jackson S; Souquette, Aisha; Reynolds, Daniel; Bender, Diane; Bosanquet, James P; Anand, Nitin J; Striker, David A; Martin, R Scott; Boon, Adrianus C M; House, Stacey L; Remy, Kenneth E; Hotchkiss, Richard S; Presti, Rachel M; O'Halloran, Jane A; Powderly, William G; Thomas, Paul G; Ellebedy, Ali H.
  • Mudd PA; Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA. pmudd@wustl.edu paul.thomas@stjude.org ellebedy@wustl.edu.
  • Crawford JC; Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA.
  • Turner JS; Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA.
  • Souquette A; Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA.
  • Reynolds D; Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Bender D; Bursky Center for Human Immunology and Immunotherapy Program, Washington University School of Medicine, Saint Louis, MO, USA.
  • Bosanquet JP; Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • Anand NJ; Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • Striker DA; Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • Martin RS; Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • Boon ACM; Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • House SL; Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Remy KE; Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Hotchkiss RS; Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.
  • Presti RM; Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA.
  • O'Halloran JA; Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Powderly WG; Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA.
  • Thomas PG; Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
  • Ellebedy AH; Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Sci Adv ; 6(50)2020 12.
Article in English | MEDLINE | ID: covidwho-927839
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cytokines / Influenza, Human / Cytokine Release Syndrome / COVID-19 / Inflammation Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cytokines / Influenza, Human / Cytokine Release Syndrome / COVID-19 / Inflammation Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Year: 2020 Document Type: Article