Open AccessInflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19
Author(s) -
Ryan S. Thwaites,
Ashley Sanchez Sevilla Uruchurtu,
Matthew K. Siggins,
Felicity Liew,
Clark D Russell,
Shona C. Moore,
Cameron J. Fairfield,
Edwin Carter,
Simon T. Abrams,
Charlotte-Eve Short,
Thilipan Thaventhiran,
Emma Bergstrom,
Zoe Gardener,
Stephanie Ascough,
Christopher Chiu,
Annemarie B Docherty,
David Hunt,
Yanick J. Crow,
Tom Solomon,
Graham P. Taylor,
Lance Turtle,
Ewen M. Harrison,
Jake Dunning,
Malcolm G. Semple,
J. Kenneth Baillie,
Peter Openshaw,
Beatrice Alex,
Benjamin Bach,
William Barclay,
Debby Bogaert,
Meera Chand,
G Cooke,
Ana da Silva Filipe,
Tom Fletcher,
Christopher Green,
Rishi K Gupta,
Julian A. Hiscox,
Antonia Ho,
Peter Horby,
Samreen Ijaz,
Saye Khoo,
Paul Klenerman,
Andrew Law,
Wei Shen Lim,
Alexander J. Mentzer,
Laura Merson,
Alison Meynert,
Mahdad Noursadeghi,
Massimo Palmarini,
Carlo Palmieri,
William A. Paxton,
Georgios Pollakis,
Nicholas Price,
Andrew Rambaut,
David Robertson,
Vanessa SanchoShimizu,
J T Scott,
Thushan I. de Silva,
Louise Sigfrid,
Shiranee Sriskandan,
David I. Stuart,
Charlotte Summers,
Richard S. Tedder,
Emma C. Thomson,
Roger Thompson AA,
Maria Zambon,
Hayley Hardwick,
Chloe Donohue,
Ronan A Lyons,
Fiona Griffiths,
Wilna Oosthuyzen,
Lisa Norman,
Riinu Pius,
Tom Drake,
Stephen R Knight,
Kenneth A McLean,
Derek Murphy,
Catherine A. Shaw,
Jo Dalton,
Michelle Girvan,
Egle Saviciute,
Stephanie Roberts,
Laura Marsh,
Marie Connor,
Sophie Halpin,
Clare Jackson,
Carrol Gamble,
Gary Leeming,
Murray Wham,
Sara Clohisey,
Ross Hendry,
James Scott-Brown,
William Greenhalf,
Victoria Shaw,
Sarah McDonald,
Seán Keating,
Katie A. Ahmed,
J. A. Armstrong,
Milton Ashworth,
Innocent G. Asiimwe,
Siddharth Bakshi,
Samantha L Barlow,
Laura Booth,
Benjamin Brennan,
Katie Bullock,
Nicola Carlucci,
Emily Cass,
Benjamin WA Catterall,
Jordan Clark,
Emily A Clarke,
Sarah Cole,
Louise Cooper,
Helen Cox,
Christopher Davis,
Oslem Dincarslan,
Alejandra Doce Carracedo,
Chris Dunn,
Philip Dyer,
Angela Elliott,
Anthony Evans,
Lorna Finch,
Lewis WS Fisher,
Lisa Flaherty,
Terry Foster,
Isabel García-Dorival,
Willliam Greenhalf,
Philip Gunning,
Catherine Hartley,
Anthony Holmes,
Rebecca L. Jensen,
Christopher B Jones,
Trevor R. Jones,
Shadia Khandaker,
Katharine King,
Robyn T. Kiy,
Chrysa Koukorava,
Annette Lake,
Suzannah Lant,
Diane Latawiec,
Lara Lavelle-Langham,
Daniella Lefteri,
Lauren Lett,
Lucia A Livoti,
Alan Maclean,
Hannah Massey,
Nicole Maziere,
Maria Vittoria Mancini,
Sarah McCafferty,
Laurence McEvoy,
John McLauchlan,
Soeren Metelmann,
Nahida S Miah,
Joanna Middleton,
Joyce Mitchell,
Kirstie Morrice,
E. Gordon Murphy,
Lee Murphy,
Rebekah Penrice-Randal,
Jack Pilgrim,
Tessa Prince,
Will Reynolds,
Paul Ridley,
Debby Sales,
Rebecca K. Shears,
Benjamin Small,
Krishanthi Subramaniam,
Agnieska Szemiel,
Aislynn Taggart,
Jolanta Tanianis-Hughes,
Jordan Thomas,
Erwan Trochu,
Libby van Tonder,
Eve Wilcock,
Nicola Wrobel,
Jihui Zhang,
Kayode Adeniji,
Daniel Agranoff,
Ken Agwuh,
Dhiraj Ail,
Erin L. Aldera,
Ana Alegria,
Brian Angus,
Abdul Ashish,
Dougal Atkinson,
Shahedal Bari,
Gavin Barlow,
Stella Barnass,
Nicholas Barrett,
Christopher Bassford,
Sneha Basude,
David Baxter,
Michael Beadsworth,
Jolanta Bernatoniene,
John C. Berridge,
Nicola Best,
Pieter Bothma,
David Brealey,
Robin Brittain-Long,
Naomi Bulteel,
Tom Burden,
Andrew Burtenshaw,
Vikki Caruth,
David Chadwick,
Duncan Chambler,
Nigel Chee,
Jenny Child,
Srikanth Chukkambotla,
Tom Clark,
Paul Collini,
Catherine Cosgrove,
Jason Cupitt,
Maria-Teresa Cutino-Moguel,
Paul Dark,
Chris Dawson,
Samir Dervisevic,
Phil Donnison,
Sam Douthwaite,
Ingrid DuRand,
Ahilanandan Dushianthan,
Tristan Dyer,
Cariad Evans,
Chi Eziefula,
Chrisopher Fegan,
Adam Finn,
Duncan Fullerton,
Sanjeev Garg,
Atul Garg,
Effrossyni GkraniaKlotsas,
Jo Godden,
Arthur Goldsmith,
Clive Graham,
Elaine Hardy,
Stuart Hartshorn,
Daniel Harvey,
Peter Havalda,
Daniel B. Hawcutt,
Maria Hobrok,
Luke Hodgson,
Anita Holme,
Anil Hormis,
Michael E. Jacobs,
Susan Jain,
Paul B. Jennings,
Agilan Kaliappan,
Vidya Kasipandian,
Stephen Kegg,
Michael Kelsey,
Jason Kendall,
Caroline Kerrison,
Ian Kerslake,
Oliver Koch,
Gouri Koduri,
George Koshy,
Shondipon Laha,
Steven Laird,
Susan Larkin,
Tamás Leiner,
Patrick Lillie,
James Limb,
Vanessa Linnett,
Jeff Little,
Mark D Lyttle,
Michael MacMahon,
Emily MacNaughton,
Ravish Mankregod,
Huw Masson,
Enock Matovu,
Katherine McCullough,
Ruth McEwen,
Manjula Meda,
Gary Mills,
Jane Minton,
Mariyam Mirfenderesky,
Kavya Mohandas,
Quen Mok,
James Moon,
Patrick Morgan,
Craig F. Morris,
Katherine Mortimore,
Samuel Moses,
Mbiye Mpenge,
Rohinton Mulla,
Michael Murphy,
Megan Nagel,
Thapas Nagarajan,
Mark E. Nelson,
Matthew K. O’Shea,
Igor Otahal,
Marlies Ostermann,
Mark Pais,
Padmasayee Papineni,
Selva Panchatsharam,
Danai Papakonstantinou,
Hassan Paraiso,
Brij Patel,
Natalie Pattinson,
Justin Pepperell,
Mark Peters,
Mandeep Phull,
Stefania Pintus,
Jagtur Singh Pooni,
Frank A. Post,
Ashley Price,
Rachel Prout,
Nikolas Rae,
Henrik Reschreiter,
Tim Reynolds,
Neil Richardson,
Mark Roberts,
Devender Roberts,
Alistair Rose,
Guy Rousseau,
Brendan Ryan,
Taranprit Saluja,
Aarti Shah,
Prad Shanmuga,
Añil Sharma,
Anna Shawcross,
Jeremy Sizer,
Manu ShankarHari,
Richard Smith,
Catherine Snelson,
Nick Spittle,
Nikki Staines,
Tom Stambach,
Richard Stewart,
Pradeep Subudhi,
Tamás Szakmány,
Kate Tatham,
J. Regan Thomas,
Chris Thompson,
Robert Thompson,
Ascanio Tridente,
Darell Tupper-Carey,
Mary Twagira,
Andrew Ustianowski,
Nick Vallotton,
Lisa Vincent-Smith,
Shico Visuvanathan,
Alan Vuylsteke,
Sam Waddy,
Rachel Wake,
Andrew Walden,
Ingeborg Welters,
Tony Whitehouse,
Paul Whittaker,
Ashley Whittington,
Meme Wijesinghe,
Martin A. K. Williams,
Lawrence Wilson,
Sarah Wilson,
Stephen Winchester,
Martin Wiselka,
Adam Wolverson,
Daniel G Wooton,
Andrew Workman,
Bryan Yates,
P. A. Young
Publication year - 2021
Publication title -
science immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 8.83
H-Index - 51
ISSN - 2470-9468
DOI - 10.1126/sciimmunol.abg9873
Subject(s) - covid-19 , disease , biology , virology , inflammation , immunology , medicine , infectious disease (medical specialty) , pathology , outbreak
While it is now widely accepted that host inflammatory responses contribute to lung injury, the pathways that drive severity and distinguish coronavirus disease 2019 (COVID-19) from other viral lung diseases remain poorly characterized. We analyzed plasma samples from 471 hospitalized patients recruited through the prospective multicenter ISARIC4C study and 39 outpatients with mild disease, enabling extensive characterization of responses across a full spectrum of COVID-19 severity. Progressive elevation of levels of numerous inflammatory cytokines and chemokines (including IL-6, CXCL10, and GM-CSF) were associated with severity and accompanied by elevated markers of endothelial injury and thrombosis. Principal component and network analyses demonstrated central roles for IL-6 and GM-CSF in COVID-19 pathogenesis. Comparing these profiles to archived samples from patients with fatal influenza, IL-6 was equally elevated in both conditions whereas GM-CSF was prominent only in COVID-19. These findings further identify the key inflammatory, thrombotic, and vascular factors that characterize and distinguish severe and fatal COVID-19.
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