Yuwei Zhang,1,* Qingshuai Sun,2,* Tao Liu,3,* Caiyun Chang,4,* Xiangjuan Chen,2 Qing Duan,1 Zixuan Wen,5 Xiaomei Zhang,1 Bo Pang,1 Xiaolin Jiang2,5,6 

1Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, People’s Republic of China; 2School of Public Health and Health Management, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, People’s Republic of China; 3Department of Infectious Disease Control, Yantai Center for Disease Control and Prevention, Yantai, Shandong Province, People’s Republic of China; 4Institute for Infectious Disease Control, Jinan Center for Disease Control and Prevention, Jinan, Shandong Province, People’s Republic of China; 5School of Public Health, Weifang Medical University, Weifang, Shandong Province, People’s Republic of China; 6Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiaolin Jiang, Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, People’s Republic of China, Tel +0531-82679767, Email jxl198607@126.com

Purpose: Severe fever with thrombocytopenia syndrome (SFTS) is an acute viral infection disease with a high mortality, but there are no specific effective drugs or vaccines available for use. To develop effective treatment methods, more basic researches are urgently needed to elucidate the response mechanisms of patients.
Patients and Methods: Here, we conducted the transcriptomic analysis of peripheral immunity in 14 SFTS patients, ranging from moderate infection to severe and fatal disease.
Results: The results showed orderly cytokine signaling pathway modulation in moderate patients, cellular immunosuppression in severe patients, and significant dysregulation of the inflammatory response and coagulation dysfunction characteristic of deceased patients. In addition, WGCNA further showed a significant positive correlation between fatal outcomes and B cell and immunoglobulin mediated immune function modules, as well as a significant negative correlation with coagulation function modules.
Conclusion: Overall, our research findings systematically observed potential immune mechanisms underlying clinical symptom heterogeneity and noteworthily revealed multiple signaling pathways leading to coagulation dysfunction in fatal outcomes, not just related to decreased platelet count, which can further elucidate the interaction between viruses and hosts and contribute to clinical treatment.

Keywords: SFTS, heterogeneous, fatal case, RNA-seq, peripheral immunity