To identify transcriptomic and immune signatures that distinguish patients with COVID-19 related ARDS requiring invasive mechanical ventilation (IMV) from those who do not.
Approach:
Study Design: A prospective observational study involving 36 patients with SARS-CoV-2 infection requiring oxygen support, comparing those on IMV (n = 11) and non-IMV (n = 25).
Data Collection: Blood samples were collected at baseline, day 4, and day 8 for transcriptomic profiling, cytokine measurement, and immune cell characterization.
Analysis Methods: RNA-sequencing for transcriptomic profiles, multiplex immunoassays for plasma cytokines, mass cytometry for immune cell endotypes, and kinetic live-cell imaging for NET formation.
Key Findings:
Transcriptomic profiling identified 36 differentially expressed genes (DEGs) at day 4 and 21 at day 8 in IMV patients, characterized by downregulation of mitochondrial gene MTARC2 and anticoagulant regulator TFPI, and upregulation of stress-response genes (RNF165, KCNMA1, and AC245014.3) (p < 0.05).
Interpretation:
Distinct transcriptomic and immune profiles were associated with severe COVID-19 in patients requiring IMV.
Limitations:
The study's findings are exploratory and require validation in larger cohorts.
The sample size was limited, with only 36 patients enrolled.
Conclusion:
The study identifies candidate biomarkers and pathways associated with severe COVID-19, necessitating further research for validation.
by Deepa B. Gotur, Diksha M. Gowda, Decha Pinkaew, Aijun Zhang, Spencer Hankins, Shaefali Rodgers, Yitian Xu, Mohi U. Syed, Tejaswini Reddy, Hong Zhao, Junjun Zheng, Rodney J. Folz, Eleftherios Mylonakis, Dale J. Hamilton
Protection against spread appeared strongest within 6 months of vaccination, while exposed vaccinated contacts showed no measurable reduction in infection risk.
