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Longitudinal peripheral blood transcriptional analysis of COVID-19 patients captures disease progression and reveals potential biomarkers

By Qihong Yan, Pingchao Li, Xianmiao Ye, Xiaohan Huang, Xiaoneng Mo, Qian Wang, Yudi Zhang, Kun Luo, Zhaoming Chen, Jia Luo, Xuefeng Niu, Ying Feng, Tianxing Ji, Bo Feng, Jinlin Wang, Feng Li, Fuchun Zhang, Fang Li, Jianhua Wang, Liqiang Feng, Zhilong Chen, Chunliang Lei, Linbing QU, Ling Chen

Posted 08 May 2020
medRxiv DOI: 10.1101/2020.05.05.20091355

COVID-19, caused by SARS-CoV-2, is an acute self-resolving disease in most of the patients, but some patients can develop a severe illness or even death. To characterize the host responses and identify potential biomarkers during disease progression, we performed a longitudinal transcriptome analysis for peripheral blood mononuclear cells (PBMCs) collected from 4 COVID-19 patients at 4 different time points from symptom onset to recovery. We found that PBMCs at different COVID-19 disease stages exhibited unique transcriptome characteristics. SARS-CoV-2 infection dysregulated innate immunity especially type I interferon response as well as the disturbed release of inflammatory cytokines and lipid mediators, and an aberrant increase of low-density neutrophils may cause tissue damage. Activation of cell death, exhaustion and migratory pathways may lead to the reduction of lymphocytes and dysfunction of adaptive immunity. COVID-19 induced hypoxia may exacerbate disorders in blood coagulation. Based on our analysis, we proposed a set of potential biomarkers for monitoring disease progression and predicting the risk of severity.

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