Tocilizumab treatment in severe COVID-19 patients attenuates the inflammatory storm incited by monocyte centric immune interactions revealed by single-cell analysis

Guo, Chuang; Li, Bin; Ma, Huan; Wang, Xiaofang; Cai, Pengfei; Yu, Qiaoni; Zhu, Lin; Jin, Liying; Jiang, Chen; Fang, Jingwen; Liu, Qian; Zong, Dandan; Zhang, Wen; Lu, Yichen; Li, Kun; Gao, Xuyuan; Fu, Binqing; Liu, Lianxin; Ma, Xiaoling; Weng, Jianping; Wei, Haiming; Jin, Tengchuan; Lin, Jun; Qu, Kun

ABSTRACTDespite the current devastation of the COVID-19 pandemic, several recent studies have suggested that the immunosuppressive drug Tocilizumab can powerfully treating inflammatory responses that occur in this disease. Here, by employing single-cell analysis of the immune cell composition of severe-stage COVID-19 patients and these same patients in post Tocilizumab-treatment remission, we have identified a monocyte subpopulation specific to severe disease that contributes to inflammatory storms in COVID-19 patients. Although Tocilizumab treatment attenuated the strong inflammatory immune response, we found that immune cells including plasma B cells and CD8+ T cells still exhibited an intense humoral and cell-mediated anti-virus immune response in COVID-19 patients after Tocilizumab treatment. Thus, in addition to providing a rich, very high-resolution data resource about the immune cell distribution at multiple stages of the COVID-19 disease, our work both helps explain Tocilizumab’s powerful therapeutic effects and defines a large number of potential new drug targets related to inflammatory storms.Competing Interest StatementJingwen Fang is the executive officer of HanGen BiotechView Full Text