Monocytes and macrophages, targets of SARS-CoV-2: the clue for Covid-19 immunoparalysis

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Abstract

To date, the Covid-19 pandemic affected more than 18 million individuals and caused more than 690, 000 deaths. Its clinical expression is pleiomorphic and severity is related to age and comorbidities such as diabetes and hypertension. The pathophysiology of the disease relies on aberrant activation of immune system and lymphopenia that has been recognized as a prognosis marker. We wondered if the myeloid compartment was affected in Covid-19 and if monocytes and macrophages could be infected by SARS-CoV-2. We show here that SARS-CoV-2 efficiently infects monocytes and macrophages without any cytopathic effect. Infection was associated with the secretion of immunoregulatory cytokines (IL-6, IL-10, TGF-β) and the induction of a macrophagic specific transcriptional program characterized by the upregulation of M2-type molecules. In addition, we found that in vitro macrophage polarization did not account for the permissivity to SARS-CoV-2, since M1-and M2-type macrophages were similarly infected. Finally, in a cohort of 76 Covid-19 patients ranging from mild to severe clinical expression, all circulating monocyte subsets were decreased, likely related to massive emigration into tissues. Monocytes from Covid-19 patients exhibited decreased expression of HLA-DR and increased expression of CD163, irrespective of the clinical status. Hence, SARS-CoV-2 drives circulating monocytes and macrophages inducing immunoparalysis of the host for the benefit of Covid-19 disease progression.

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  1. SciScore for 10.1101/2020.09.17.300996: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Immunofluorescence: After a 24 or 48-hour infection, cells were incubated in blocking buffer (Phosphate buffer saline (PBS) supplemented with 5% FBS and 0.5% Triton X-100) for 30 minutes and washed before incubation with an anti-SARS-CoV-2 spike protein antibody (Life Technologies).
    anti-SARS-CoV-2 spike protein
    suggested: None
    Flow cytometry: PBMCs from healthy donors or Covid-19 patients were resuspended in PBS (Life Technologies) containing 5% FBS and 2mM EDTA (Sigma-Aldrich) for 20 minutes before staining using the following fluorochrome-conjugated antibodies (mouse IgG1): CD3 (UCHT1), CD20 (B9E9), CD14 (RMO52), CD16 (3G8) purchased from Beckman Coulter, Paris, France; HLA-DR (G46-6) and CD163 (GHI/61) from BD Biosciences, Le Pont de Claix, France, and appropriate isotype controls.
    mouse IgG1)
    suggested: None
    CD20
    suggested: (BioLegend Cat# 348805, RRID:AB_2889063)
    CD14
    suggested: (BioLegend Cat# 348805, RRID:AB_2889063)
    RMO52
    suggested: None
    CD16
    suggested: None
    3G8
    suggested: None
    G46-6
    suggested: None
    CD163
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Virus production and cell infection: SARS-CoV-2 strain IHU-MI3 was obtained after Vero E6 cells (American type culture collection ATCC® CRL-1586(tm)) infection in Minimum Essential Media (MEM) (Life Technologies) supplemented with 4% FBS as previously described (20).
    Vero E6
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Virus production and cell infection: SARS-CoV-2 strain IHU-MI3 was obtained after Vero E6 cells (American type culture collection ATCC® CRL-1586(tm)) infection in Minimum Essential Media (MEM) (Life Technologies) supplemented with 4% FBS as previously described (20).
    SARS-CoV-2
    suggested: None
    Software and Algorithms
    SentencesResources
    A minimum of 50,000 events were acquired for each sample using a BD Canto II instrument (BD Biosciences) and data were analyzed with FlowJo software (Tree Star, Ashland, OR).
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Statistical analysis: Statistical analysis was performed with GraphPad Prism (7.0, La Jolla, CA), using the two-way ANOVA test for viral quantification (Ct values) and transcriptional analysis, nonparametric Kruskall-Wallis test for group comparison, nonparametric Mann-Whitney U test for cytokine levels, and nonparametric t-test for flow cytometry results with monocyte populations and surface marker expression.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    qRT-PCR data for monocytes and macrophages, including principal component analysis (PCA) and hierarchical clustering of gene expression, were analyzed using the ClustVis webtool (23).
    ClustVis
    suggested: (ClustVis, RRID:SCR_017133)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on page 24. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.