SARS-CoV-2 viremia is associated with distinct proteomic pathways and predicts COVID-19 outcomes

被引:96
作者
Li, Yijia [1 ,2 ]
Schneider, Alexis M. [3 ,4 ]
Mehta, Arnav [2 ,3 ,5 ,6 ]
Sade-Feldman, Moshe [2 ,3 ,6 ]
Kays, Kyle R. [2 ]
Gentili, Matteo [3 ]
Charland, Nicole C. [2 ]
Gonye, Anna L. K. [2 ,3 ,6 ]
Gushterova, Irena [2 ,3 ,6 ]
Khanna, Hargun K. [2 ]
LaSalle, Thomas J. [2 ,3 ,6 ]
Lavin-Parsons, Kendall M. [2 ]
Lilley, Brendan M. [2 ]
Lodenstein, Carl L. [2 ]
Manakongtreecheep, Kasidet [2 ,3 ]
Margolin, Justin D. [2 ]
McKaig, Brenna N. [2 ]
Parry, Blair A. [2 ]
Rojas-Lopez, Maricarmen [7 ,8 ]
Russo, Brian C. [7 ,8 ]
Sharma, Nihaarika [2 ,3 ]
Tantivit, Jessica [2 ,3 ,9 ]
Thomas, Molly F. [2 ,3 ,9 ]
Regan, James [1 ]
Flynn, James P. [1 ]
Villani, Alexandra-Chloe [2 ,3 ,9 ]
Hacohen, Nir [2 ,3 ,6 ]
Goldberg, Marcia B. [2 ,3 ,7 ,8 ]
Filbin, Michael R. [2 ,3 ]
Li, Jonathan Z. [1 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, 65 Landsdowne St,Room 421, Boston, MA 02139 USA
[2] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA 02139 USA
[3] Broad Inst MIT & Harvard, Cambridge, MA 02142 USA
[4] MIT, Dept Biol Engn, 77 Massachusetts Ave, Cambridge, MA 02139 USA
[5] Harvard Med Sch, Dana Farber Canc Inst, Boston, MA 02115 USA
[6] Massachusetts Gen Hosp, Dept Med, Ctr Canc Res, Boston, MA 02114 USA
[7] Massachusetts Gen Hosp, Dept Med, Ctr Bacterial Pathogenesis, Div Infect Dis, Boston, MA 02114 USA
[8] Harvard Med Sch, Dept Microbiol, Boston, MA 02115 USA
[9] Massachusetts Gen Hosp, Dept Med, Ctr Immunol & Inflammatory Dis, Boston, MA 02114 USA
基金
美国国家卫生研究院;
关键词
VIRAL-RNA DETECTION; SPIKE PROTEIN; CORONAVIRUS; DISEASE; BLOOD;
D O I
10.1172/JCI148635
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
BACKGROUND. SARS-CoV-2 plasma viremia has been associated with severe disease and death in COVID-19 in small-scale cohort studies. The mechanisms behind this association remain elusive. METHODS. We evaluated the relationship between SARS-CoV-2 viremia, disease outcome, and inflammatory and proteomic profiles in a cohort of COVID-19 emergency department participants. SARS-CoV-2 viral load was measured using a quantitative reverse transcription PCR-based platform. Proteomic data were generated with Proximity Extension Assay using the Olink platform. RESULTS. This study included 300 participants with nucleic acid test-confirmed COVID-19. Plasma SARS-CoV-2 viremia levels at the time of presentation predicted adverse disease outcomes, with an adjusted OR of 10.6 (95% CI 4.4-25.5, P < 0.001) for severe disease (mechanical ventilation and/or 28-day mortality) and 3.9 (95% CI 1.5-10.1, P = 0.006) for 28-day mortality. Proteomic analyses revealed prominent proteomic pathways associated with SARS-CoV-2 viremia, including upregulation of SARS-CoV-2 entry factors (ACE2, CTSL, FURIN), heightened markers of tissue damage to the lungs, gastrointestinal tract, and endothelium/vasculature, and alterations in coagulation pathways. CONCLUSION. These results highlight the cascade of vascular and tissue damage associated with SARS-CoV-2 plasma viremia that underlies its ability to predict COVID-19 disease outcomes.
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页数:13
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[51]   Compromised Humoral Functional Evolution Tracks with SARS-CoV-2 Mortality [J].
Zohar, Tomer ;
Loos, Carolin ;
Fischinger, Stephanie ;
Atyeo, Caroline ;
Wang, Chuangqi ;
Slein, Matthew D. ;
Burke, John ;
Yu, Jingyou ;
Feldman, Jared ;
Hauser, Blake Marie ;
Caradonna, Tim ;
Schmidt, Aaron G. ;
Cai, Yongfei ;
Streeck, Hendrik ;
Ryan, Edward T. ;
Barouch, Dan H. ;
Charles, Richelle C. ;
Lauffenburger, Douglas A. ;
Alter, Galit .
CELL, 2020, 183 (06) :1508-+