Plasma proteomic profiles correlate with organ dysfunction in COVID-19 ARDS

Area of Science:

• Pulmonary Medicine
• Proteomics
• Critical Care

Background:

• Severe COVID-19 frequently leads to hypoxemic respiratory failure and acute respiratory distress syndrome (ARDS).
• The underlying mechanisms of lung injury and repair in ARDS are not fully understood.
• Identifying biomarkers could improve understanding and treatment of ARDS.

Purpose of the Study:

• To investigate plasma proteomic profiles in patients with COVID-19 ARDS.
• To identify protein biomarkers associated with ARDS severity and disease progression.
• To explore biological pathways linked to lung injury and repair in ARDS.

Main Methods:

• Plasma proteome analysis of 32 COVID-19 ARDS patients using an aptamer-based platform (7289 proteins).
• Correlation of protein abundance with Sequential Organ Failure Assessment (SOFA) scores at ICU days 1 and 7.
• Longitudinal analysis of protein changes and SOFA score dynamics between days 1 and 7.

Main Results:

• 184 proteins correlated with SOFA at day 1; 46 proteins correlated with SOFA at day 7.
• 40 proteins showed significant longitudinal correlation with SOFA score changes.
• Pathway analysis revealed increased ephrin and acute phase response signaling with worsening SOFA scores, and decreased pulmonary fibrosis and wound healing signaling.

Conclusions:

• Plasma proteomics can identify biomarkers for COVID-19 ARDS severity.
• Persistent inflammation appears to drive disease severity, while repair processes correlate with improved organ function.
• This proteomic approach can be applied to future ARDS cohorts to discover mechanisms and guide targeted therapies.