Cited by 952COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 ResearchLong-Term Effects of COVID-19

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A dynamic COVID-19 immune signature includes associations with poor prognosis

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Laing, Adam G., Lorenc, Anna, del Molino del Barrio, Irene, Das, Abhishek, Fish, Matthew, Monin, Leticia, Muñoz-Ruiz, Miguel, McKenzie, Duncan R., Hayday, Thomas S., Francos-Quijorna, Isaac, Kamdar, Shraddha, Joseph, Magdalene, Davies, Daniel, Davis, Richard, Jennings, Aislinn, Zlatareva, Iva, Vantourout, Pierre, Wu, Yin, Sofra, Vasiliki, Cano, Florencia, Greco, Maria, Theodoridis, Efstathios, Freedman, Joshua D., Gee, Sarah, Chan, Julie Nuo En, Ryan, Sarah, Bugallo-Blanco, Eva, Peterson, Pärt, Kisand, Kai, Haljasmägi, Liis, Chadli, Loubna, Moingeon, Philippe, Martinez, Lauren, Merrick, Blair, Bisnauthsing, Karen, Brooks, Kate, Ibrahim, Mohammad A. A., Mason, Jeremy, Lopez Gomez, Federico, Babalola, Kola, Abdul-Jawad, Sultan, Cason, John, Mant, Christine, Seow, Jeffrey, Graham, Carl, Doores, Katie J., Di Rosa, Francesca, Edgeworth, Jonathan, Shankar-Hari, Manu, Hayday, Adrian C.·2020·Nature Medicine

DOI 10.1038/s41591-020-1038-6

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Abstract

Improved understanding and management of COVID-19, a potentially life-threatening disease, could greatly reduce the threat posed by its etiologic agent, SARS-CoV-2. Toward this end, we have identified a core peripheral blood immune signature across 63 hospital-treated patients with COVID-19 who were otherwise highly heterogeneous. The signature includes discrete changes in B and myelomonocytic cell composition, profoundly altered T cell phenotypes, selective cytokine/chemokine upregulation and SARS-CoV-2-specific antibodies. Some signature traits identify links with other settings of immunoprotection and immunopathology; others, including basophil and plasmacytoid dendritic cell depletion, correlate strongly with disease severity; while a third set of traits, including a triad of IP-10, interleukin-10 and interleukin-6, anticipate subsequent clinical progression. Hence, contingent upon independent validation in other COVID-19 cohorts, individual traits within this signature may collectively and individually guide treatment options; offer insights into COVID-19 pathogenesis; and aid early, risk-based patient stratification that is particularly beneficial in phasic diseases such as COVID-19.

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Authors: Laing, A. G., Lorenc, A., del Molino del Barrio, I., Das, A., Fish, M., Monin, L., Muñoz-Ruiz, M., McKenzie, D. R., Hayday, T. S., Francos-Quijorna, I., Kamdar, S., Joseph, M., Davies, D., Davis, R., Jennings, A., Zlatareva, I., Vantourout, P., Wu, Y., Sofra, V., Cano, F., Greco, M., Theodoridis, E., Freedman, J. D., Gee, S., Chan, J. N. E., Ryan, S., Bugallo-Blanco, E., Peterson, P., Kisand, K., Haljasmägi, L., Chadli, L., Moingeon, P., Martinez, L., Merrick, B., Bisnauthsing, K., Brooks, K., Ibrahim, M. A. A., Mason, J., Lopez Gomez, F., Babalola, K., Abdul-Jawad, S., Cason, J., Mant, C., Seow, J., Graham, C., Doores, K. J., Di Rosa, F., Edgeworth, J., Shankar-Hari, M., & Hayday, A. C.
Affiliations: King's College London (GB)
Guy's Hospital (GB)
The Francis Crick Institute (GB)
Royal Free London NHS Foundation Trust (GB)
University of Tartu (EE)
Servier (France) (FR)
Guy's and St Thomas' NHS Foundation Trust (GB)
King's College Hospital NHS Foundation Trust (GB)
European Bioinformatics Institute (GB)
Corresponding author: Hayday, Adrian C.
ORCID: Laing, Adam G.
Lorenc, Anna
Das, Abhishek
Fish, Matthew
Monin, Leticia
McKenzie, Duncan R.
Hayday, Thomas S.
Francos-Quijorna, Isaac
Kamdar, Shraddha
Joseph, Magdalene
Davies, Daniel
Davis, Richard
Jennings, Aislinn
Zlatareva, Iva
Vantourout, Pierre
Wu, Yin
Cano, Florencia
Greco, Maria
Freedman, Joshua D.
Gee, Sarah
Chan, Julie Nuo En
Ryan, Sarah
Bugallo-Blanco, Eva
Peterson, Pärt
Kisand, Kai
Haljasmägi, Liis
Chadli, Loubna
Moingeon, Philippe
Martinez, Lauren
Merrick, Blair
Bisnauthsing, Karen
Brooks, Kate
Ibrahim, Mohammad A. A.
Mason, Jeremy
Lopez Gomez, Federico
Babalola, Kola
Abdul-Jawad, Sultan
Mant, Christine
Seow, Jeffrey
Doores, Katie J.
Edgeworth, Jonathan
Shankar-Hari, Manu
Hayday, Adrian C.
Venue: Nature Medicine
Publisher: Springer Science and Business Media LLC
Published: 2020-08-17
Volume: 26
Issue: 10
Pages: 1623-1635
ISSN: 1078-8956 (ISSN-L)
1546-170X
DOI: 10.1038/s41591-020-1038-6
OpenAlex: W3049325061
Cited by: 946
References: 94
Citations by year: 2026: 24 · 2025: 50 · 2024: 110 · 2023: 123 · 2022: 216 · 2021: 322 · 2020: 97
FWCI: 25.06
Type: journal article
Language: en
Update notices: correction (2020-11-27)
correction (2020-09-09)
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature Medicine (publishedVersion)
medRxiv (acceptedVersion)
PubMed (publishedVersion)
Funders: Wellcome Trust (106292/Z/4/Z)
National Institute for Academic Anaesthesia (WKR0-2018-0047)
Topics: Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Keywords: COVID-19 pandemic, SARS-CoV-2, immune signatures, peripheral immune cells, B cells, myelomonocytic cells, T cell phenotype, cytokines and chemokines, SARS-CoV-2 antibodies, plasmacytoid dendritic cells, disease severity, prognostic factors, CXCL10, IL-10, interleukin-6, patient stratification
MeSH terms: Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Antibodies, Viral, B-Lymphocytes, Basophils, Cell Cycle, Dendritic Cells, Female, Flow Cytometry, Hospitalization, Humans, Immunologic Memory, Leukocyte Count, Lymphocyte Activation, Male, Middle Aged, Pneumonia, Viral, Prognosis, Severity of Illness Index, T-Lymphocytes, Cohort Studies, Interleukin-6, Up-Regulation, Case-Control Studies, Immunophenotyping, B-Lymphocyte Subsets, T-Lymphocyte Subsets, Cytokines, Interleukin-10, Coronavirus Infections, Disease Progression, Chemokines, Chemokine CXCL10, Pandemics

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A dynamic COVID-19 immune signature includes associations with poor prognosis

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