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Role of immune-inflammatory biomarkers and their derived ratio in predicting COVID-19 severity and mortality
Sara I Taha1, Shaimaa H Fouad2, Eman M El-Sehsah3
1Department of Clinical Pathology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt. dr_sara_ib@med.asu.edu.eg.
Insights
MicroRNA-155 (miR-155) and cytokine levels like IL-6 and IL-10 are elevated in COVID-19 patients. Higher miR-155 expression correlates with increased COVID-19 severity and mortality, suggesting its potential as a biomarker.
Area of Science:
- Immunology
- Molecular Biology
- Genetics
Background:
- COVID-19 pathogenesis involves complex cytokine interactions influenced by genetic factors.
- MicroRNA-155 (miR-155) and specific interleukins (IL-6, IL-10) are implicated in inflammatory responses.
Purpose of the Study:
- To investigate the association between COVID-19 severity and mortality with miR-155 expression.
- To explore the relationship between miR-155, IL-6, and IL-10 serum levels in COVID-19 patients.
Main Methods:
- A pilot case-control study involving 75 COVID-19 patients and 25 healthy controls.
- Serum cytokine levels measured by ELISA; miR-155 expression assessed using quantitative real-time PCR.
Main Results:
- COVID-19 patients exhibited significantly higher levels of IL-6, IL-10, IL-6/IL-10 ratio, and miR-155 compared to controls.
- miR-155 expression was highest in severe COVID-19 cases, ICU patients, and non-survivors.
- miR-155 showed a negative correlation with IL-10 and a positive correlation with the IL-6/IL-10 ratio, acting as an independent risk factor and predictor of severity.
Conclusions:
- Elevated cytokines and miR-155 expression are characteristic of COVID-19.
- miR-155 levels are strongly associated with COVID-19 severity, ICU admission, and mortality.
- miR-155 shows potential as a biomarker for monitoring COVID-19 progression and guiding patient management.
Abstract:
The pathogenesis of the coronavirus disease 2019 (COVID-19) involves a complex group of cytokines and is significantly influenced by genetic and epigenetic factors. The current study aims to assess the association of COVID-19 severity and mortality with the relative expression of MicroRNA-155 (miR-155) and its association with serum levels of interleukin (IL)-6, IL-10, and their derived ratio. This pilot case-control study included 75 COVID-19 patients and 25 healthy controls. Serum levels of cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA), and assessment of miR-155 relative expression level was done using quantitative real-time PCR in all participants. We found that IL-6, IL-10, IL-6/IL-10 ratio, and miR-155 expression levels were significantly higher in COVID-19 patients than in healthy controls (p-values < 0.001). The expression level of miR-155 showed significant differences between all severity categories of COVID-19, reaching its highest levels in the severe group. It was also significantly higher in ICU-admitted patients (p-value < 0.001) and those who died during their hospital stay (p-value = 0.001). It showed a significant negative correlation with serum IL-10 (r=-0.249, p-value = 0.031) and a significant positive correlation with IL-6/IL-10 ratio (r = 0.234, p-value = 0.043). It was also the only independent risk factor for COVID-19 severity by regression analysis and the best predictor for COVID-19 severity by ROC curve analysis. This study reported elevation of cytokines and miR-155 expression in COVID-19 patients. The level of miR-155 expression was associated with COVID-19 severity, mortality, and ICU admission, indicating its potential utility as a biomarker for monitoring the progression of COVID-19 and guiding patient follow-up.
