1
|
Yekelchyk M, Madan E, Wilhelm J, Short KR, Palma AM, Liao L, Camacho D, Nkadori E, Winters MT, Rice ES, Rolim I, Cruz‐Duarte R, Pelham CJ, Nagane M, Gupta K, Chaudhary S, Braun T, Pillappa R, Parker MS, Menter T, Matter M, Haslbauer JD, Tolnay M, Galior KD, Matkwoskyj KA, McGregor SM, Muller LK, Rakha EA, Lopez‐Beltran A, Drapkin R, Ackermann M, Fisher PB, Grossman SR, Godwin AK, Kulasinghe A, Martinez I, Marsh CB, Tang B, Wicha MS, Won KJ, Tzankov A, Moreno E, Gogna R. Flower lose, a cell fitness marker, predicts COVID-19 prognosis. EMBO Mol Med 2021; 13:e13714. [PMID: 34661368 PMCID: PMC8573598 DOI: 10.15252/emmm.202013714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 01/08/2023] Open
Abstract
Risk stratification of COVID-19 patients is essential for pandemic management. Changes in the cell fitness marker, hFwe-Lose, can precede the host immune response to infection, potentially making such a biomarker an earlier triage tool. Here, we evaluate whether hFwe-Lose gene expression can outperform conventional methods in predicting outcomes (e.g., death and hospitalization) in COVID-19 patients. We performed a post-mortem examination of infected lung tissue in deceased COVID-19 patients to determine hFwe-Lose's biological role in acute lung injury. We then performed an observational study (n = 283) to evaluate whether hFwe-Lose expression (in nasopharyngeal samples) could accurately predict hospitalization or death in COVID-19 patients. In COVID-19 patients with acute lung injury, hFwe-Lose is highly expressed in the lower respiratory tract and is co-localized to areas of cell death. In patients presenting in the early phase of COVID-19 illness, hFwe-Lose expression accurately predicts subsequent hospitalization or death with positive predictive values of 87.8-100% and a negative predictive value of 64.1-93.2%. hFwe-Lose outperforms conventional inflammatory biomarkers and patient age and comorbidities, with an area under the receiver operating characteristic curve (AUROC) 0.93-0.97 in predicting hospitalization/death. Specifically, this is significantly higher than the prognostic value of combining biomarkers (serum ferritin, D-dimer, C-reactive protein, and neutrophil-lymphocyte ratio), patient age and comorbidities (AUROC of 0.67-0.92). The cell fitness marker, hFwe-Lose, accurately predicts outcomes in COVID-19 patients. This finding demonstrates how tissue fitness pathways dictate the response to infection and disease and their utility in managing the current COVID-19 pandemic.
Collapse
Affiliation(s)
- Michail Yekelchyk
- Department of Cardiac Development and RemodellingMax Planck Institute for Heart and Lung ResearchBad NauheimGermany
| | - Esha Madan
- Champalimaud Centre for the UnknownLisbonPortugal
| | - Jochen Wilhelm
- Universities Giessen & Marburg Lung CenterGerman Center for Lung Research (DZL)Justus‐Liebig‐UniversityGiessenGermany
- Institute for Lung Health (ILH)Universities Giessen & Marburg Lung CenterGerman Center for Lung Research (DZL)Justus‐Liebig‐University GiessenGiessenGermany
| | - Kirsty R Short
- School of Chemistry and Molecular BiosciencesThe University of QueenslandBrisbaneQldAustralia
| | | | - Linbu Liao
- Biotech Research and Innovation Centre (BRIC)University of CopenhagenCopenhagen NDenmark
| | | | - Everlyne Nkadori
- Department of Pathology and Laboratory MedicineUniversity of Wisconsin Carbone Cancer CenterUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWIUSA
| | - Michael T Winters
- Department of MicrobiologyImmunology & Cell Biology and WVU Cancer InstituteWest Virginia UniversityMorgantownWVUSA
| | - Emily S Rice
- Department of MicrobiologyImmunology & Cell Biology and WVU Cancer InstituteWest Virginia UniversityMorgantownWVUSA
| | - Inês Rolim
- Champalimaud Centre for the UnknownLisbonPortugal
| | - Raquel Cruz‐Duarte
- Instituto de Medicina Molecular João Lobo AntunesFaculdade de MedicinaUniversidade de LisboaLisboaPortugal
| | | | - Masaki Nagane
- Department of BiochemistrySchool of Veterinary MedicineAzabu UniversityKanagawaJapan
| | - Kartik Gupta
- Department of SurgerySchool of Medicine and Public HealthUniversity of WisconsinMadisonWIUSA
| | - Sahil Chaudhary
- Department of SurgerySchool of Medicine and Public HealthUniversity of WisconsinMadisonWIUSA
| | - Thomas Braun
- Department of Cardiac Development and RemodellingMax Planck Institute for Heart and Lung ResearchBad NauheimGermany
- Member of the German Center for Cardiovascular Research (DZHK)GreifswaldGermany
| | - Raghavendra Pillappa
- Department of PathologyVirginia Commonwealth University School of MedicineRichmondVAUSA
| | - Mark S Parker
- Department of Diagnostic Radiology and Internal Medicine, Early Detection Lung Cancer Screening Program, Thoracic Imaging Division, Thoracic Imaging Fellowship ProgramVCU Health SystemsRichmondVAUSA
| | - Thomas Menter
- Pathology, Institute of Medical Genetics and PathologyUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Matthias Matter
- Pathology, Institute of Medical Genetics and PathologyUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Jasmin Dionne Haslbauer
- Pathology, Institute of Medical Genetics and PathologyUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Markus Tolnay
- Pathology, Institute of Medical Genetics and PathologyUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Kornelia D Galior
- Department of Pathology and Laboratory MedicineUniversity of Wisconsin Carbone Cancer CenterUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWIUSA
| | - Kristina A Matkwoskyj
- Department of Pathology and Laboratory MedicineUniversity of Wisconsin Carbone Cancer CenterUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWIUSA
| | - Stephanie M McGregor
- Department of Pathology and Laboratory MedicineUniversity of Wisconsin Carbone Cancer CenterUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWIUSA
| | - Laura K Muller
- Department of Pathology and Laboratory MedicineUniversity of Wisconsin Carbone Cancer CenterUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWIUSA
| | - Emad A Rakha
- Division of Cancer and Stem CellsDepartment of PathologySchool of MedicineNottingham University HospitalsUniversity of NottinghamNottinghamUK
| | - Antonio Lopez‐Beltran
- Champalimaud Centre for the UnknownLisbonPortugal
- Department of Morphological SciencesCordoba UniversityCordobaSpain
| | - Ronny Drapkin
- Penn Ovarian Cancer Research CenterDepartment of Obstetrics and GynecologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
- Graduate Program in Cell and Molecular BiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
- Basser Center for BRCAAbramson Cancer CenterUniversity of Pennsylvania School of MedicinePhiladelphiaPAUSA
| | - Maximilian Ackermann
- Institute of Pathology and Molecular PathologyHelios University Clinic WuppertalUniversity of Witten/HerdeckeWuppertalGermany
- Institute of Functional and Clinical AnatomyUniversity Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Paul B Fisher
- Department of Human and Molecular GeneticsSchool of MedicineVirginia Commonwealth UniversityRichmondVAUSA
- Massey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
- Department of Human and Molecular GeneticsInstitute of Molecular MedicineSchool of MedicineVirginia Commonwealth UniversityRichmondVAUSA
| | - Steven R Grossman
- Department of Internal MedicineKeck School of MedicineNorris Comprehensive Cancer CenterLos AngelesCAUSA
- University of Southern CaliforniaLos AngelesCAUSA
| | - Andrew K Godwin
- Department of Pathology and Laboratory MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
- University of Kansas Cancer CenterKansas CityKSUSA
| | - Arutha Kulasinghe
- The University of Queensland Diamantina InstituteThe University of QueenslandBrisbaneQldAustralia
| | - Ivan Martinez
- Department of MicrobiologyImmunology & Cell Biology and WVU Cancer InstituteWest Virginia UniversityMorgantownWVUSA
| | - Clay B Marsh
- Department of MicrobiologyImmunology & Cell Biology and WVU Cancer InstituteWest Virginia UniversityMorgantownWVUSA
| | - Benjamin Tang
- Department of Intensive Care MedicineNepean HospitalPenrithNSWAustralia
| | - Max S Wicha
- Rogel Cancer CenterUniversity of MichiganAnn ArborMIUSA
- Department of Internal MedicineMichigan MedicineUniversity of MichiganAnn ArborMIUSA
| | - Kyoung Jae Won
- Biotech Research and Innovation Centre (BRIC)University of CopenhagenCopenhagen NDenmark
- Faculty of Health and Medical SciencesNovo Nordisk Foundation Center for Stem Cell Biology, DanStemUniversity of CopenhagenCopenhagen NDenmark
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and PathologyUniversity Hospital Basel and University of BaselBaselSwitzerland
| | | | - Rajan Gogna
- Champalimaud Centre for the UnknownLisbonPortugal
- Biotech Research and Innovation Centre (BRIC)University of CopenhagenCopenhagen NDenmark
- Faculty of Health and Medical SciencesNovo Nordisk Foundation Center for Stem Cell Biology, DanStemUniversity of CopenhagenCopenhagen NDenmark
| |
Collapse
|