Critically ill COVID-19 patients exhibit peripheral immune profiles predictive of mortality and reflective of SARS-CoV-2 viral burden in the lung

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Cell Rep Med. 2021 Dec 2:100476. doi: 10.1016/j.xcrm.2021.100476. Online ahead of print.


Despite extensive analyses, there remains an urgent need to delineate immune cell states that contribute to mortality in critically ill Coronavirus disease 2019 (COVID-19) patients. Here, we present high-dimensional profiling of blood and respiratory samples in severe COVID-19 patients to examine the association between cell-linked molecular features and mortality outcomes. Peripheral transcriptional profiles by single-cell RNAseq based deconvolution of immune states are associated with COVID-19 mortality. Further, persistently high levels of an interferon signaling module in monocytes over time leads to subsequent concerted upregulation of inflammatory cytokines. SARS-CoV-2 infected myeloid cells in the lower respiratory tract upregulate CXCL10, leading to a higher risk of death. Our analysis suggests a pivotal role for viral infected myeloid cells and protracted interferon signaling in severe COVID-19.

PMID:34873589 | PMC:PMC8636386 | DOI:10.1016/j.xcrm.2021.100476