Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19

Abstract

Background: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, December 2019, and continuously poses a serious threat to public health, highlighting the urgent need of identifying biomarkers for disease severity and progression. Objective: To identify biomarkers for disease severity and progression of COVID-19. Methods: Forty-eight cytokines in the plasma samples from 50 COVID-19 cases including 11 critically ill, 25 severe and 14 moderate patients were measured and analyzed in combination with clinical data. Results: Fourteen cytokines were found to be significantly elevated in COVID-19 cases and showed different expression profiles in patients with different disease severity. Moreover, expression levels of IP-10, MCP-3, HGF, MIG and MIP-1α, which were shown to be highly associated with disease severity during disease progression, were remarkably higher in critically ill patients, followed by severe and then the moderate patients. Serial detection of the five cytokines in 16 cases showed that continuously high levels were associated with deteriorated progression of disease and fatal outcome. Furthermore, IP-10 and MCP-3 were excellent predictors for the progression of COVID-19, and the combination of the two cytokines showed the biggest area under the curve (AUC) of the receiver-operating characteristics (ROC) calculations with a value of 0.99. Conclusion: In this study, we report biomarkers that highly associated with disease severity and progression of COVID-19. These findings add to our understanding of the immunopathologic mechanisms of SARS-CoV-2 infection, and provide potential therapeutic targets and strategies. Clinical Implications: Continuously high levels of IP-10, MCP-3, HGF, MIG and MIP-1α contribute to the disease deterioration and adverse outcome of COVID-19. IP-10 and MCP-3 could predict the progression of COVID-19. Capsule summary: Cytokine storm occurred during SARS-CoV-2 infection and contributed to the disease progression. Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19.