Background: We evaluated how plasma proteomic signatures in patients with suspected COVID-19 can unravel the pathophysiology, and determine kinetics and clinical outcome of the infection. Methods: Plasma samples from patients presenting to the emergency department (ED) with symptoms of COVID-19 were stratified into: (1) patients with suspected COVID-19 that was not confirmed ( n = 44); (2) non-hospitalized patients with confirmed COVID-19 ( n = 44); (3) hospitalized patients with confirmed COVID-19 ( n = 53) with variable outcome; and (4) patients presenting to the ED with minor diseases unrelated to SARS-CoV-2 infection ( n = 20). Besides standard of care diagnostics, 177 circulating proteins related to inflammation and cardiovascular disease were analyzed using proximity extension assay (PEA, Olink) technology. Results: Comparative proteome analysis revealed 14 distinct proteins as highly associated with SARS-CoV-2 infection and 12 proteins with subsequent hospitalization ( p < 0.001). ADM, IL-6, MCP-3, TRAIL-R2, and PD-L1 were each predictive for death (AUROC curve 0.80–0.87). The consistent increase of these markers, from hospital admission to intensive care and fatality, supported the concept that these proteins are of major clinical relevance. Conclusions: We identified distinct plasma proteins linked to the presence and course of COVID-19. These plasma proteomic findings may translate to a protein fingerprint, helping to assist clinical management decisions.
【저자키워드】 COVID-19, proteomics, risk prediction, proximity extension assay, emergency medicine, 【초록키워드】 Inflammation, intensive care, Hospitalization, IL-6, SARS-COV-2 infection, Infection, cardiovascular disease, proximity extension assay, diagnostics, emergency department, PD-L1, Clinical outcome, Protein, Kinetics, pathophysiology, Patient, death, Clinical management, plasma, Hospital admission, proteome, disease, proteomic, plasma proteins, fatality, Analysis, Predictive, plasma protein, Comparative, Standard of care, plasma samples, circulating, AUROC, MCP-3, symptoms of COVID-19, TRAIL, helping, Course, analyzed, subsequent, evaluated, supported, determine, hospitalized patient, presenting, translate, assist, stratified, ADM, 【제목키워드】 SARS-CoV-2, clinical, fingerprint,