Distinct Inflammatory Profiles Distinguish COVID-19 from Influenza with Limited Contributions from Cytokine Storm

Authors

  • Philip A. Mudd Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Jeremy Chase Crawford Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA.
  • Jackson S. Turner Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA.
  • Aisha Souquette Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA.
  • Daniel Reynolds Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Diane Bender Bursky Center for Human Immunology and Immunotherapy Program, Washington University School of Medicine, Saint Louis, MO, USA.
  • James P. Bosanquet Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • Nitin J. Anand Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • David A. Striker Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • R. Scott Martin Department of Critical Care, Missouri Baptist Medical Center, Saint Louis, MO, USA.
  • Adrianus C. M. Boon Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA.
  • Stacey L. House Department of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Kenneth E. Remy Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA, Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA and Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA.
  • Richard S. Hotchkiss Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA, Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA and Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
  • Rachel M. Presti Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Jane A. O’Halloran Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • William G. Powderly Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
  • Paul G. Thomas Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA.
  • Ali H. Ellebedy Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA, Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, USA and Bursky Center for Human Immunology and Immunotherapy Program, Washington University School of Medicine, Saint Louis, MO, USA.

DOI:

https://doi.org/10.9734/bpi/mono/978-81-19039-63-0/CH3

Keywords:

COVID-19, influenza, cytokine, single-cell transcriptional profiling

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.

Published

2023-02-09

How to Cite

Philip A. Mudd, Jeremy Chase Crawford, Jackson S. Turner, Aisha Souquette, Daniel Reynolds, Diane Bender, … Ali H. Ellebedy. (2023). Distinct Inflammatory Profiles Distinguish COVID-19 from Influenza with Limited Contributions from Cytokine Storm. Diagnostic and Treatment Advances in COVID-19 and SARS-CoV-2, 19–50. https://doi.org/10.9734/bpi/mono/978-81-19039-63-0/CH3

Issue

Diagnostic and Treatment Advances in COVID-19 and SARS-CoV-2

Section

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