Circulating cardiovascular microRNAs in critically ill COVID-19 patients
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Updated: Nov 22, 2025
Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
Ankita Garg1, Benjamin Seeliger2, Anselm A Derda1,3
1Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany.
Insights
Critically ill COVID-19 patients show elevated levels of cardiac and inflammatory microRNAs (miRs). These microRNA profiles can distinguish COVID-19 from Influenza-ARDS, suggesting specific cardiac involvement in severe COVID-19.
Area of Science:
- Biomedical research
- Cardiovascular medicine
- Infectious diseases
Background:
- Coronavirus disease 2019 (COVID-19) poses a significant global health threat with severe socio-economic impacts.
- The SARS-CoV-2 virus utilizes the angiotensin-converting enzyme 2 receptor, which is also expressed on cardiac cells, raising concerns about cardiovascular burden in COVID-19 patients.
- MicroRNAs (miRs) are sensitive biomarkers for cardiovascular damage and inflammation.
Purpose of the Study:
- To investigate the levels of cardiovascular and inflammatory miRs in critically ill patients with COVID-19 and Influenza-associated acute respiratory distress syndrome (Influenza-ARDS).
- To determine if miR profiles can differentiate between COVID-19 and Influenza-ARDS patients.
- To explore the potential cardiac involvement in severe COVID-19 cases.
Main Methods:
- Serum samples were collected from mechanically ventilated COVID-19 patients, Influenza-ARDS patients, and healthy controls.
- Concentrations of specific miRs (miR-21, miR-126, miR-155, miR-208a, and miR-499) were measured using miR-specific TaqMan PCR analyses.
- Receiver operating characteristic (ROC) analysis was employed to assess the diagnostic potential of miR profiles.
Main Results:
- Serum concentrations of miR-21, miR-155, miR-208a, and miR-499 were significantly elevated in COVID-19 patients compared to healthy controls.
- ROC analysis indicated that miR-155, miR-208a, and miR-499 could effectively distinguish between COVID-19 and Influenza-ARDS patients.
- These findings suggest an upregulation of inflammation and cardiac myocyte-specific miRs in critically ill COVID-19 patients.
Conclusions:
- Critically ill COVID-19 patients exhibit increased levels of inflammation and cardiac-specific microRNAs.
- MicroRNA profiling demonstrates potential in differentiating between severe COVID-19 and Influenza-ARDS.
- The results indicate a specific inflammatory response and potential cardiac involvement associated with COVID-19.
Aims:
Coronavirus disease 2019 (COVID-19) is a still growing pandemic, causing many deaths and socio-economic damage. Elevated expression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptor angiotensin-converting enzyme 2 on cardiac cells of patients with heart diseases may be related to cardiovascular burden. We have thus analysed cardiovascular and inflammatory microRNAs (miRs), sensitive markers of cardiovascular damage, in critically ill, ventilated patients with COVID-19 or influenza-associated acute respiratory distress syndrome (Influenza-ARDS) admitted to the intensive care unit and healthy controls.
Methods And Results:
Circulating miRs (miR-21, miR-126, miR-155, miR-208a, and miR-499) were analysed in a discovery cohort consisting of patients with mechanically-ventilated COVID-19 (n = 18) and healthy controls (n = 15). A validation study was performed in an independent cohort of mechanically-ventilated COVID-19 patients (n = 20), Influenza-ARDS patients (n = 13) and healthy controls (n = 32). In both cohorts, RNA was isolated from serum and cardiovascular disease/inflammatory-relevant miR concentrations were measured by miR-specific TaqMan PCR analyses. In both the discovery and the validation cohort, serum concentration of miR-21, miR-155, miR-208a and miR-499 were significantly increased in COVID-19 patients compared to healthy controls. Calculating the area under the curve using receiver operating characteristic analysis miR-155, miR-208a and miR-499 showed a clear distinction between COVID-19 and Influenza-ARDS patients.
Conclusion:
In this exploratory study, inflammation and cardiac myocyte-specific miRs were upregulated in critically ill COVID-19 patients. Importantly, miR profiles were able to differentiate between severely ill, mechanically-ventilated Influenza-ARDS and COVID-19 patients, indicating a rather specific response and cardiac involvement of COVID-19.
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