Dysregulated transcriptional responses to SARS-CoV-2 in the periphery

Micah T. McClain (), Florica J. Constantine, Ricardo Henao, Yiling Liu, Ephraim L. Tsalik, Thomas W. Burke, Julie M. Steinbrink, Elizabeth Petzold, Bradly P. Nicholson, Robert Rolfe, Bryan D. Kraft, Matthew S. Kelly, Daniel R. Saban, Chen Yu, Xiling Shen, Emily M. Ko, Gregory D. Sempowski, Thomas N. Denny, Geoffrey S. Ginsburg and Christopher W. Woods
Additional contact information
Micah T. McClain: Durham Veterans Affairs Medical Center
Florica J. Constantine: Duke University
Ricardo Henao: Duke University
Yiling Liu: Duke University
Ephraim L. Tsalik: Durham Veterans Affairs Medical Center
Thomas W. Burke: Duke University
Julie M. Steinbrink: Duke University
Elizabeth Petzold: Duke University
Bradly P. Nicholson: Institute for Medical Research
Robert Rolfe: Duke University Medical Center
Bryan D. Kraft: Durham Veterans Affairs Medical Center
Matthew S. Kelly: Duke University Medical Center
Daniel R. Saban: Duke University School of Medicine
Chen Yu: Duke University School of Medicine
Xiling Shen: Duke University
Emily M. Ko: Duke University
Gregory D. Sempowski: Duke Human Vaccine Institute
Thomas N. Denny: Duke Human Vaccine Institute
Geoffrey S. Ginsburg: Duke University
Christopher W. Woods: Durham Veterans Affairs Medical Center

Nature Communications, 2021, vol. 12, issue 1, 1-8

Abstract: Abstract SARS-CoV-2 infection has been shown to trigger a wide spectrum of immune responses and clinical manifestations in human hosts. Here, we sought to elucidate novel aspects of the host response to SARS-CoV-2 infection through RNA sequencing of peripheral blood samples from 46 subjects with COVID-19 and directly comparing them to subjects with seasonal coronavirus, influenza, bacterial pneumonia, and healthy controls. Early SARS-CoV-2 infection triggers a powerful transcriptomic response in peripheral blood with conserved components that are heavily interferon-driven but also marked by indicators of early B-cell activation and antibody production. Interferon responses during SARS-CoV-2 infection demonstrate unique patterns of dysregulated expression compared to other infectious and healthy states. Heterogeneous activation of coagulation and fibrinolytic pathways are present in early COVID-19, as are IL1 and JAK/STAT signaling pathways, which persist into late disease. Classifiers based on differentially expressed genes accurately distinguished SARS-CoV-2 infection from other acute illnesses (auROC 0.95 [95% CI 0.92–0.98]). The transcriptome in peripheral blood reveals both diverse and conserved components of the immune response in COVID-19 and provides for potential biomarker-based approaches to diagnosis.

Date: 2021
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DOI: 10.1038/s41467-021-21289-y

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