@article{418bc1f96f4b4cc8bc5232e37439b18a,
title = "Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm",
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.",
author = "Mudd, {Philip A.} and Crawford, {Jeremy Chase} and Turner, {Jackson S.} and Aisha Souquette and Daniel Reynolds and Diane Bender and Bosanquet, {James P.} and Anand, {Nitin J.} and Striker, {David A.} and Martin, {R. Scott} and Boon, {Adrianus C.M.} and House, {Stacey L.} and Remy, {Kenneth E.} and Hotchkiss, {Richard S.} and Presti, {Rachel M.} and O{\textquoteright}Halloran, {Jane A.} and Powderly, {William G.} and Thomas, {Paul G.} and Ellebedy, {Ali H.}",
note = "Funding Information: We would like to thank J. Rolando, A. Day, B. Flint, E. Raines, and support staff in the Washington University Emergency Care and Research Core for the hard work and personal dedication to collecting COVID-19 patient samples. We thank the Genome Technology Access Center (GTAC@MGI) in the Department of Genetics and McDonnell Genome Institute at Washington University School of Medicine. GTAC@MGI is partially supported by NCI Cancer Center Support grant number P30 CA91842 to the Siteman Cancer Center and by ICTS/CTSA grant number UL1 TR000448 from NCATS. We also thank the Bursky Center for Human Immunology and Immunotherapy Programs at Washington University, Immunomonitoring Laboratory. Funding: This work was supported by a grant from the Barnes Jewish Hospital Foundation to P.A.M.; by grants NIAID R21 AI139813, U01 AI141990, Collaborative Influenza Vaccine Innovation Centers contract 75N93019C00051, and NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C to A.H.E.; and by the St. Jude Center of Excellence for Influenza Research and Surveillance (HHSN272201400006C), R01AI121832, and ALSAC to P.G.T. The COVID-19 clinical cohort reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR002345 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily Publisher Copyright: Copyright {\textcopyright} 2020 The Authors",
year = "2020",
month = dec,
day = "9",
doi = "10.1126/sciadv.abe3024",
language = "English",
volume = "6",
journal = "Science Advances",
issn = "2375-2548",
number = "50",
}