Dysregulated transcriptional responses to SARS-CoV-2 in the periphery support novel diagnostic approaches.

Journal Article

In order to elucidate novel aspects of the host response to SARS-CoV-2 we performed RNA sequencing on peripheral blood samples across 77 timepoints from 46 subjects with COVID-19 and compared them to subjects with seasonal coronavirus, influenza, bacterial pneumonia, and healthy controls. Early SARS-CoV-2 infection triggers a conserved transcriptomic response in peripheral blood that is heavily interferon-driven but also marked by indicators of early B-cell activation and antibody production. Interferon responses during SARS-CoV-2 infection demonstrate unique patterns of dysregulated expression compared to other infectious and healthy states. Heterogeneous activation of coagulation and fibrinolytic pathways are present in early COVID-19, as are IL1 and JAK/STAT signaling pathways, that persist into late disease. Classifiers based on differentially expressed genes accurately distinguished SARS-CoV-2 infection from other acute illnesses (auROC 0.95). The transcriptome in peripheral blood reveals unique aspects of the immune response in COVID-19 and provides for novel biomarker-based approaches to diagnosis.

Full Text

Duke Authors

Cited Authors

  • McClain, MT; Constantine, FJ; Henao, R; Liu, Y; Tsalik, EL; Burke, TW; Steinbrink, JM; Petzold, E; Nicholson, BP; Rolfe, R; Kraft, BD; Kelly, MS; Sempowski, GD; Denny, TN; Ginsburg, GS; Woods, CW

Published Date

  • July 26, 2020

Published In

  • Medrxiv

PubMed ID

  • 32743603

Pubmed Central ID

  • PMC7386527

Digital Object Identifier (DOI)

  • 10.1101/2020.07.20.20155507


  • eng

Conference Location

  • United States