Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Sci Adv. 2020 Dec 9;6(50). doi: 10.1126/sciadv.abe3024. Print 2020 Dec.
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.
我们研究了 2019 冠状病毒病（COVID-19）和流感患者的免疫反应。与流感患者相比，COVID-19 患者的淋巴细胞计数大致相当，单核细胞较少，选定的单核细胞群体表面人白细胞抗原（HLA）-II 类表达水平较低。此外，中间单核细胞 HLA-DR 的降低预示着 COVID-19 疾病的严重程度。与普遍的假设相反，只有少数（168 例中的 7 例）COVID-19 患者表现出细胞因子风暴综合征的细胞因子谱。在控制了年龄和样本时间点等多个因素后，COVID-19 患者的细胞因子水平低于流感患者。IL-6、G-CSF、IL-1RA 和 MCP1 的上调预示着 COVID-19 患者的死亡，但与流感患者相比并没有统计学上的更高。单细胞转录组谱分析显示 COVID-19 患者的干扰素信号受到严重抑制。从外周免疫谱的全谱来看，COVID-19 患者的炎症反应低于流感患者。
