JCI Insight (May 2021)

The relationship between cytokine and neutrophil gene network distinguishes SARS-CoV-2–infected patients by sex and age

  • Paula P. Freire,
  • Alexandre H.C. Marques,
  • Gabriela C. Baiocchi,
  • Lena F. Schimke,
  • Dennyson L.M. Fonseca,
  • Ranieri C. Salgado,
  • Igor S. Filgueiras,
  • Sarah M.S. Napoleao,
  • Desirée R. Plaça,
  • Karen T. Akashi,
  • Thiago Dominguez Crespo Hirata,
  • Nadia El Khawanky,
  • Lasse M. Giil,
  • Gustavo Cabral-Miranda,
  • Robson F. Carvalho,
  • Luis Carlos S. Ferreira,
  • Antonio Condino-Neto,
  • Helder I. Nakaya,
  • Igor Jurisica,
  • Hans D. Ochs,
  • Niels Olsen Saraiva Camara,
  • Vera Lúcia G. Calich,
  • Otavio Cabral-Marques

Journal volume & issue
Vol. 6, no. 10

Abstract

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The fact that the COVID-19 fatality rate varies by sex and age is poorly understood. Notably, the outcome of SARS-CoV-2 infections mostly depends on the control of cytokine storm and the increasingly recognized pathological role of uncontrolled neutrophil activation. Here, we used an integrative approach with publicly available RNA-Seq data sets of nasopharyngeal swabs and peripheral blood leukocytes from patients with SARS-CoV-2, according to sex and age. Female and young patients infected by SARS-CoV-2 exhibited a larger number of differentially expressed genes (DEGs) compared with male and elderly patients, indicating a stronger immune modulation. Among them, we found an association between upregulated cytokine/chemokine- and downregulated neutrophil-related DEGs. This was correlated with a closer relationship between female and young subjects, while the relationship between male and elderly patients was closer still. The association between these cytokine/chemokines and neutrophil DEGs is marked by a strongly correlated interferome network. Here, female patients exhibited reduced transcriptional levels of key proinflammatory/neutrophil-related genes, such as CXCL8 receptors (CXCR1 and CXCR2), IL-1β, S100A9, ITGAM, and DBNL, compared with male patients. These genes are well known to be protective against inflammatory damage. Therefore, our work suggests specific immune-regulatory pathways associated with sex and age of patients infected with SARS-CoV-2 and provides a possible association between inverse modulation of cytokine/chemokine and neutrophil transcriptional signatures.

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