极简的转录基因签名允许准确的早期预测COVID-19死亡率
Rithwik Narendra1,2, Emily C Lydon1, Hoang Van Phan1
1University of California San Francisco, San Francisco, CA 94115, USA.
medRxiv : the preprint server for health sciences
|June 6, 2025
概括
一种新的三基因血液特征和OLAH基因准确地预测了住院后48小时内COVID-19死亡率. 这些发现为COVID-19患者的早期干预和资源分配提供了可访问的预后工具,包括接种疫苗的人.
科学领域:
- 基因组学和转录基因组学
- 传染病流行病学 传染病流行病学
- 临床预后 临床预后
背景情况:
- 预测COVID-19死亡率仍然是一个重大的临床挑战.
- 准确的预后分析对于及时的患者管理至关重要.
- 这项研究解决了对可靠的COVID-19早期死亡率预测的未满足需求.
研究的目的:
- 识别和验证用于预测COVID-19死亡率的节转录组签名.
- 开发可访问的预测工具,用于早期风险分层.
- 在未接种疫苗和接种疫苗的患者中评估这些签名的性能.
主要方法:
- 使用RNA测序对894名住院COVID-19患者宿主基因表达的分析.
- 开发使用LASSO回归的预后分类器,包括基因表达,年龄和病毒载量.
- 在137名COVID-19患者的独立队列中进行外部验证,包括接种疫苗的个人.
主要成果:
- 致命的COVID-19显示出不同的外周血液基因表达模式,与败血症不同.
- 一个三基因的外周血液分类器 (CD83,ATP1B2,DAAM2) 实现了0.88.8的AUC.
- 仅仅OLAH基因就显示出强大的预测性能 (AUC 0.86),并且分类器在接种疫苗的患者中得到了验证.
结论:
- 一个三基因的外周血液特征和OLAH基因表达准确地预测了COVID-19在住院早期的死亡率.
- 这些分类器有望成为指导临床决策的可访问的预后工具.
- 需要进一步的研究来实现这些签名用于分拣和早期治疗干预.
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