Research ArticleCORONAVIRUS

Longitudinal immune profiling reveals key myeloid signatures associated with COVID-19

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Science Immunology  17 Sep 2020:
Vol. 5, Issue 51, eabd6197
DOI: 10.1126/sciimmunol.abd6197

Myeloid upheaval in severe COVID-19

Severe COVID-19 disease is associated with immune hyperactivation accompanied by “cytokine storm.” Mann et al. used longitudinal analysis of fresh blood samples from hospitalized COVID-19 patients to search for biomarkers that signal impending progression to severe disease. Several phenotypic and functional abnormalities of CD14+ blood monocytes emerged as early-stage biomarkers predictive of increased severity of disease. Monocytes from patients with severe COVID-19 activated in vitro with lipopolysaccharide displayed increased proliferation and decreased expression of the prostaglandin-synthesizing cyclooxygenase-2 (COX-2) enzyme. Premature release of immature myeloid cells from the bone marrow contributes to innate immune dysfunction, causing more extensive lung damage and poorer clinical outcomes. These findings suggest that early treatment of COVID-19 targeting emergency myelopoiesis may help reduce the risk of subsequent clinical deterioration.

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