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

Philip A Mudd1, Jeremy Chase Crawford2, Jackson S Turner3

  • 1Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA. pmudd@wustl.edu paul.thomas@stjude.org ellebedy@wustl.edu.

Science Advances
|November 14, 2020
PubMed

Insights

Patients with COVID-19 show distinct immune responses compared to influenza, with lower inflammation and suppressed interferon signaling. Decreased HLA-DR on monocytes predicts severe COVID-19, challenging previous assumptions about cytokine storm syndrome.

Area of Science:

  • Immunology
  • Virology
  • Infectious Diseases

Background:

  • Immune responses to respiratory viruses like COVID-19 and influenza are critical for disease outcomes.
  • Understanding differences in immune cell profiles and cytokine expression can inform treatment strategies.

Purpose of the Study:

  • To compare immune responses in patients with COVID-19 and influenza.
  • To identify immune markers associated with COVID-19 severity and mortality.

Main Methods:

  • Comparative analysis of peripheral blood immune cells (lymphocytes, monocytes) and surface marker expression (HLA-class II).
  • Quantification of cytokine profiles and assessment of cytokine storm syndrome indicators.
  • Single-cell transcriptional profiling to analyze gene expression, particularly interferon signaling pathways.

Main Results:

  • COVID-19 patients had similar lymphocyte counts but fewer monocytes and lower HLA-class II expression on monocytes compared to influenza patients.
  • Reduced HLA-DR expression on intermediate monocytes predicted severe COVID-19.
  • Most COVID-19 patients did not exhibit cytokine storm profiles; overall cytokine levels were lower than in influenza patients.
  • Suppressed interferon signaling was observed in COVID-19 patients.
  • Elevated IL-6, G-CSF, IL-1RA, and MCP1 predicted death in COVID-19 patients.

Conclusions:

  • COVID-19 patients exhibit a less inflamed peripheral immune profile than influenza patients.
  • Specific monocyte subset alterations and suppressed interferon responses characterize COVID-19 immune pathology.
  • Immune profiling offers insights into disease severity and prognosis for COVID-19.

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