Convergent and divergent immune aberrations in COVID-19, post-COVID-19-Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis

We aimed to study transcriptional and phenotypic changes in circulating immune cells associated with increased risk of mortality in COVID-19, resolution of pulmonary fibrosis in post-COVID-19-Interstitial Lung Disease (ILD) and persistence of Idiopathic Pulmonary Fibrosis. Whole blood and Peripheral Blood Mononuclear cells (PBMC) were obtained from 227 subjects with COVID-19, post-COVID-19 Interstitial Lung Disease (ILD), IPF and controls. We measured a 50-gene signature (nCounter, Nanostring) previously found to be predictive of IPF and COVID-19 mortality along with plasma levels of several biomarkers by Luminex. Additionally, we performed single-cell RNA sequencing in PBMC (10X Genomics) to determine the cellular source of the 50-gene signature. We identified the presence of three genomic risk profiles in COVID-19 based on the 50-gene signature associated with low, intermediate, or high-risk of mortality and with significant differences in pro-inflammatory and pro-fibrotic cytokines. COVID-19 patients in the high-risk group had increased expression of seven genes in CD14