A blood atlas of COVID-19 defines hallmarks of disease severity and specificity

Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete description of specific immune biomarkers. We present here a comprehensive multi-omic blood atlas for patients with varying COVID-19 severity in an integrated comparison with influenza and sepsis patients versus healthy volunteers. We identify immune signatures and correlates of host response. Hallmarks of disease severity involved cells, their inflammatory mediators and networks, including progenitor cells and specific myeloid and lymphocyte subsets, features of the immune repertoire, acute phase response, metabolism, and coagulation. Persisting immune activation involving AP-1/p38MAPK was a specific feature of…

• GS
  Gilead Sciences

  Award: KENN151612 KENN192004 KENN171803
• WT
  Wellcome Trust
• UR
  UK Research and Innovation

  Award: MR/S005471/1
• CR
  Cancer Research UK
• NI
  National Institute for Health and Care Research
• BH
  British Heart Foundation
• DO
  Department of Health and Social Care
• RS
  Royal Society
• KM
  Kennedy Memorial Trust
• UO
  University of Oxford
• RT
  Rosetrees Trust
• CA
  Chinese Academy of Sciences
• CA
  Chinese Academy of Medical Sciences

  Awards: IFMS 2018-I2M-2-002, CRUK C130623/A249471
• NI
  National Institutes of Health

  Award: U192U19AI082630 R24DK106766
• MR
  Medical Research Council

  Awards: MC_UU_00008/10, MCUU00016/14 12009/14 MR/S035850/1 MCPC19059, MC_PC_20002, MR/S020918/1, MR/S025308/1, MC_UU_00029/3, MR/T014067/1, MR/S005471/1, MC_UU_00016/1, MR/V010182/1, MR/X001210/1, MC_UU_00008/6, MR/L006340/1, MC_UU_00008/5
• EA
  Engineering and Physical Sciences Research Council

  Awards: EP/R005125/1, EP/R018472/1 EP/R005125/1 EP/T001968/1, EP/R018472/1