A consensus Covid-19 immune signature combines immuno-protection with discrete sepsis-like traits associated with poor prognosis
Adam G. Laing,
Irene del Molino del Barrio,
Duncan R. McKenzie,
Thomas S. Hayday,
Isaac Francos Quijorna,
Julie Nuo En, Chan,
Eva Bugallo Blanco,
Federico Lopez Gomez,
Sultan Abdul- Jawad,
Katie J Doores,
Francesca Di Rosa,
Jonathan D. Edgeworth,
Adrian Adrian C. Hayday
Posted 09 Jun 2020
medRxiv DOI: 10.1101/2020.06.08.20125112
Posted 09 Jun 2020
Person-to-person transmission of SARS-CoV-2 virus has triggered a global emergency because of its potential to cause life-threatening Covid-19 disease. By comparison to pauci-symptomatic virus clearance by most individuals, Covid-19 has been proposed to reflect insufficient and/or pathologically exaggerated immune responses. Here we identify a consensus peripheral blood immune signature across 63 hospital-treated Covid-19 patients who were otherwise highly heterogeneous. The core signature conspicuously blended adaptive B cell responses typical of virus infection or vaccination with discrete traits hitherto associated with sepsis, including monocyte and dendritic cell dampening, and hyperactivation and depletion of discrete T cell subsets. This blending of immuno-protective and immuno-pathogenic potentials was exemplified by near-universal CXCL10/IP10 upregulation, as occurred in SARS1 and MERS. Moreover, specific parameters including CXCL10/IP10 over-expression, T cell proliferation, and basophil and plasmacytoid dendritic cell depletion correlated, often prognostically, with Covid-19 progression, collectively composing a resource to inform SARS-CoV-2 pathobiology and risk-based patient stratification.
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