Art by Sophia Zhao.
COVID-19 is a fickle foe, exhibiting mild symptoms in some individuals, severe pain and pneumonia in others, or in forty percent of cases, simply no signs at all. Anticipating the degree of disease severity before onset could be critical to providing patients with appropriate care.
A team of Yale researchers led by immunologist Akiko Iwasaki set out to uncover the molecular and cellular bases for the divergence in COVID-19’s disease trajectories. Specifically, the team identified and tracked four “immune signatures”—growth factors, type-2/3 cytokines, mixed type-1/2/3 cytokines, and chemokines that correlated with the distinct disease trajectories of patients—in 113 patients with either moderate or severe COVID-19. The longitudinal study found that patients with moderate disease maintained low expression levels of cytokines even as the disease progressed. However, patients with severe disease had elevated levels of all four signatures. Using early cytokine markers to predict the severity of disease onset and inform treatment for COVID-19 patients at an early stage will likely save many lives.