Research ArticleCORONAVIRUS

Inflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19

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Science Immunology  10 Mar 2021:
Vol. 6, Issue 57, eabg9873
DOI: 10.1126/sciimmunol.abg9873

GM-CSF is a targetable marker of COVID-19 severity

Critical respiratory failure in COVID-19 is an inflammatory disease—several proinflammatory factors correlate with disease severity in COVID-19, and anti-inflammatory treatments such as corticosteroids and anti–IL-6 monoclonal antibodies can reduce mortality. There is a need to identify additional “targetable” proinflammatory factors that correlate with disease severity. Here, Thwaites et al. analyzed the plasma of 471 hospitalized COVID-19 patients, finding that IL-6 and GM-CSF were substantially elevated in those with severe disease. GM-CSF was elevated in cases of fatal COVID-19, but not in fatal influenza, whereas IL-6 was elevated in both. Thus, elevated GM-CSF distinguishes severe COVID-19 from severe influenza, providing insights into disease pathogenesis and a theoretical rationale for therapeutic inhibition of GM-CSF in COVID-19. Inhibitor studies are now ongoing in COVID-19.

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This is an open-access article distributed under the terms of the Creative Commons Attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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