New COVID-19 Biomarker Discovery – Can Predict Patient Death or Hospitalization

In a new study, researchers from the University of Copenhagen show that the phenomenon of cell fitness could predict the host’s immune response to a COVID-19 infection. The discovery could prove important for pandemic management.

While parts of the western world are slowly returning to normal, many low- and middle-income countries are still fighting and fearing new outbreaks of COVID-19. And for most, it feels almost unbearable to endure another wave of the virus, which could lead to more deaths and long-lasting symptoms of COVID-19 infection.

In a new study, researchers from the University of Copenhagen present what could be a much-needed helping hand to fight the virus. The study shows that analysis of a particular protein on the cell surface can likely predict who is at risk of serious infection caused by the virus, explains assistant professor Rajan Gogna, lead author of the new study.

“Cells have a so-called fitness status and by analyzing it we could predict hospitalization or death in COVID-19 patients, potentially making such a biomarker an earlier prediction tool, especially since it can be detected with the common nasal swab covid-19 tests ”, says Rajan Gogna of the Won Group of the Biotech Research & Innovation Center.

If the cell fitness status is poor, it indicates that the cell is not developing properly, either because the cell is senescent, not reliable, has a poorly functioning metabolism or is disease prone, etc. Earlier in 2021, the research team found that fitness status is expressed in proteins called flour proteins. These flower proteins are located on the surface of the cell and are expressed in two forms, explains Rajan Gogna.

“In one form, they tell the surrounding cells that this cell is doing well. In the other form, they indicate to the surrounding tissue that this particular cell is not doing well and is therefore in poor condition. If the condition of the cell is not great, the cell will be phased out and killed by the surrounding cells.”

Accurate prediction of severe infection

Particularly useful in cases of early stage COVID-19 disease, flower protein expression can accurately predict hospitalization or death, as well as predict who would have a less severe infection.

“The method was able to predict who needed hospitalization with an accuracy of 78.7 percent. With COVID-19 patients who would not have a serious infection, the prediction was accurate at 93.9 percent,” said associate professor and group leader Kyoung Jae Won, who analyzed the data using machine learning.

To analyze the data, the researchers conducted a postmortem study of the infected lung tissue in deceased COVID-19 patients to determine the biological role of flower proteins in acute lung injury, the leading cause of death from the disease.

Using nasal swabs, they also conducted an observational study to evaluate whether the protein expression could accurately predict hospitalization or death.

“The cell fitness expressed by the flower protein could help explain why some people respond poorly to COVID-19 and provide the opportunity for pre-identification of high-risk individuals. This discovery has the potential to save their lives by giving them serious warnings for extra self-protection, or until they’re lucky enough to get their hands on a vaccine. In some other countries, the general population has a great reluctance to vaccinate. But people don’t hesitate about a test and we hope it will improve the results,” says Rajan Gogna.

Cellular fitness isn’t just about your age

Cellular fitness is relative to many things in our bodies and does not necessarily change with age. Age has an impact, but the researchers have seen many cases from their database where people aged 80 years have a very good fitness profile of the lungs, the main area where cell fitness is measured to predict the outcome of a COVID-19 infection, explains. Rajan Gogna out.

“We have also seen young people die in countries such as India, Indonesia and Brazil. Because not only age, but also co-morbidities affect the fitness level of the cell in both the upper and lower airways. Insulin signalling, diabetes and hypertension are also known to play a role in determining cell fitness,” says Rajan Gogna.

The researchers hope their discovery comes at the right time, given the persistence of COVID-19 and the increasing cases and deaths in several countries outside the Western world despite vaccines.

“In many countries, the population needs protection from the worst consequences. We believe these places could benefit from our discovery,” said Rajan Gogna.

Reference: “Blood loss, a cell fitness marker, predicts the prognosis of COVID-19” by Michail Yekelchyk, Esha Madan, Jochen Wilhelm, Kirsty R Short, António M Palma, Linbu Liao, Denise Camacho, Everlyne Nkadori, Michael T Winters, Emily S Rice , Inês Rolim, Raquel Cruz-Duarte, Christopher J Pelham, Masaki Nagane, Kartik Gupta, Sahil Chaudhary, Thomas Braun, Raghavendra Pillappa, Mark S Parker, Thomas Menter, Matthias Matter, Jasmin Dionne Haslbauer, Markus Tolnay, Kornelia D Galior, Kristina A Matkwoskyj, Stephanie M McGregor, Laura K Muller, Emad A Rakha, Antonio Lopez-Beltran, Ronny Drapkin, Maximilian Ackermann, Paul B Fisher, Steven R Grossman, Andrew K Godwin, Arutha Kulasinghe, Ivan Martinez, Clay B Marsh, Benjamin Tang , Max S Wicha, Kyoung Jae Won, Alexandar Tzankov, Eduardo Moreno and Rajan Gogna, October 18, 2021, EMBO Molecular Medicine.
DOI: 10.15252/emmm.202013714