Immune Signature Linked to COVID-19 Severity: A SARS-Score for Personalized Medicine

Front Immunol. 2021 Jul 12:12:701273. doi: 10.3389/fimmu.2021.701273. eCollection 2021.

Abstract

SARS-CoV-2 infection leads to a highly variable clinical evolution, ranging from asymptomatic to severe disease with acute respiratory distress syndrome, requiring intensive care units (ICU) admission. The optimal management of hospitalized patients has become a worldwide concern and identification of immune biomarkers predictive of the clinical outcome for hospitalized patients remains a major challenge. Immunophenotyping and transcriptomic analysis of hospitalized COVID-19 patients at admission allow identifying the two categories of patients. Inflammation, high neutrophil activation, dysfunctional monocytic response and a strongly impaired adaptive immune response was observed in patients who will experience the more severe form of the disease. This observation was validated in an independent cohort of patients. Using in silico analysis on drug signature database, we identify differential therapeutics that specifically correspond to each group of patients. From this signature, we propose a score-the SARS-Score-composed of easily quantifiable biomarkers, to classify hospitalized patients upon arrival to adapt treatment according to their immune profile.

Keywords: COVID-19; immunologic profile; personalized medicine/personalized health care; score; therapeutic strategy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptive Immunity / genetics
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • Biomarkers
  • COVID-19 / immunology*
  • COVID-19 / therapy
  • Cohort Studies
  • Female
  • Hospitalization
  • Humans
  • Inflammation / genetics
  • Male
  • Middle Aged
  • Precision Medicine
  • Prospective Studies
  • SARS-CoV-2 / physiology*
  • Severity of Illness Index
  • Transcriptome

Substances

  • Antiviral Agents
  • Biomarkers