2021
DOI: 10.1126/sciadv.abe5984
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A diagnostic host response biosignature for COVID-19 from RNA profiling of nasal swabs and blood

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease-19 (COVID-19), has emerged as the cause of a global pandemic. We used RNA sequencing to analyze 286 nasopharyngeal (NP) swab and 53 whole-blood (WB) samples from 333 patients with COVID-19 and controls. Overall, a muted immune response was observed in COVID-19 relative to other infections (influenza, other seasonal coronaviruses, and bacterial sepsis), with paradoxical down-regulation of several key differentially ex… Show more

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Cited by 83 publications
(83 citation statements)
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References 66 publications
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“…We also profiled the host transcriptional profile of the nasal epithelium in a subset of patients. As recently described (Butler et al, 2021;Islam et al, 2021;Lieberman et al, 2020;Ng et al, 2021), we observed an upregulation of genes associated with innate immune cell activation, antiviral defense, inflammation, and cell death. Furthermore, the upregulation of genes associated with neuronal death and the downregulation of genes influencing epithelial integrity and sensory organ development support a mechanism for infection-induced anosmia and ageusia (de Melo et al, 2021;Melo et al, 2021;Rawson and Huang, 2009).…”
Section: Accesssupporting
confidence: 80%
“…We also profiled the host transcriptional profile of the nasal epithelium in a subset of patients. As recently described (Butler et al, 2021;Islam et al, 2021;Lieberman et al, 2020;Ng et al, 2021), we observed an upregulation of genes associated with innate immune cell activation, antiviral defense, inflammation, and cell death. Furthermore, the upregulation of genes associated with neuronal death and the downregulation of genes influencing epithelial integrity and sensory organ development support a mechanism for infection-induced anosmia and ageusia (de Melo et al, 2021;Melo et al, 2021;Rawson and Huang, 2009).…”
Section: Accesssupporting
confidence: 80%
“…Our findings highlight an upregulation of genes associated with innate immune cell activation, antiviral defense, and inflammation as recently described (72,73). We also observed a transcriptional signature associated with cell death which has been proposed as a key biosignature of COVID-19 infection (74,75). Furthermore, the robust upregulation of genes associated with neuronal death and downregulation of genes influencing epithelial integrity and sensory organ development supports a mechanism for infection-induced anosmia and ageusia was not certified by peer review) is the author/funder.…”
Section: Discussionsupporting
confidence: 83%
“…We showed that the mucosal IFN-I/III signature was correlated with the blood IFN-I signature. Two recent studies have also reported a strong induction of ISGs in the nasal mucosa of SARS-CoV-2-infected patients, which was even higher compared with patients infected with other viruses, such as influenza or seasonal coronaviruses (Mick et al, 2020;Ng et al, 2021), confirming that a high ISGs expression is a hallmark of anti-SARS-CoV-2 mucosal immunity (Pizzorno et al, 2020). Interestingly, another study has also reported that the nasal ISGs expression was higher in pediatric than in adult patients infected with SARS-CoV-2 (Pierce et al, 2021), which could explain the differences in disease severity observed between these two populations.…”
Section: Discussionmentioning
confidence: 95%