COVID-19 patients with high TNF/IFN-γ levels show hallmarks of PANoptosis, an inflammatory cell death.

TNF and IFN-γ trigger cell damage during SARS CoV-2 infection; these cytokines can induce senescence and a cell death process called PANoptosis. This study included 138 vaccine-naïve COVID-19 patients, who were divided into four groups (Gp) according to the plasma level of TNF and IFN-γ (High [ ^Hi ] or Normal-Low [ ^No-Low ]), Gp 1: TNF ^Hi /IFNγ ^Hi ; Gp 2: TNF ^Hi /IFNγ ^No-Low ; Gp 3: TNF ^No-Low /IFNγ ^Hi ; and Gp 4: TNF ^No-Low /IFNγ ^No-Low . Thirty-five apoptosis-related proteins and molecules related to cell death and senescence were evaluated. Our results showed that groups did not display differences in age and comorbidities. However, 81% of the Gp 1 patients had severe COVID-19, and 44% died. Notably, the p21/CDKN1A was increased in Gp 2 and Gp 3. Moreover, Gp 1 showed higher TNFR1, MLKL, RIPK1, NLRP3, Caspase 1, and HMGB-1 levels, suggesting elevated TNF and IFN-γ levels simultaneously activate diverse cell death pathways because it is not observed when only one of these cytokines is increased. Thus, high TNF/IFN-γ levels are predominant in severe COVID-19 status, and patients display cell alterations associated with the activation of diverse cell death pathways, including a possible senescent phenotype.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
(Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)