Immunologic evaluation shows that most COVID-19 patients exhibit targeted immunosuppression compared to patients with influenza. 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.
【초록키워드】 COVID-19, coronavirus disease, Monocytes, immune response, IL-6, Influenza, Immunosuppression, Cytokine storm syndrome, immune, Antigen, monocyte, death, interferon signaling, age, expression, patients, HLA-DR, cytokine profile, severe COVID-19 disease, COVID-19 patient, leukocyte, Factor, profiles, G-CSF, IL-1ra, lymphocyte counts, up-regulation, MCP1, Immunologic, populations, transcriptional, selected, predicted, exhibited, less, statistically, cytokine level, patients with COVID-19, patients with influenza, 【제목키워드】 COVID-19, Cytokine storm, Influenza, Inflammatory, profile,