Blood molecular markers associated with COVID‐19 immunopathology and multi‐organ damage

Abstract

COVID‐19 is characterised by dysregulated immune responses, metabolic dysfunction and adverse effects on the function of multiple organs. To understand host responses to COVID‐19 pathophysiology, we combined transcriptomics, proteomics, and metabolomics to identify molecular markers in peripheral blood and plasma samples of 66 COVID‐19 patients experiencing a range of disease severities and 17 healthy controls. A large number of expressed genes, proteins, metabolites and extracellular RNAs (exRNAs) exhibit strong associations with various clinical parameters. Multiple sets of tissue‐specific proteins and exRNAs varied significantly in both mild and severe patients suggesting a potential impact on tissue function. Chronic activation of neutrophils, IFN‐I signalling as well as a high level of inflammatory cytokines were observed in patients with severe disease progression. In contrast, COVID‐19 patients experiencing milder disease symptoms showed robust T cell responses. Finally, we identified genes, proteins and exRNAs as potential biomarkers that might assist in predicting the prognosis of SARS‐CoV‐2 infection. These data refine our understanding of the pathophysiology and clinical progress of COVID‐19.