Searching for biomarkers of disease severity in COVID-19 patients

COVID-19 is a new and aggressive infectious disease. It is hard to predict disease progression based on clinical respiratory symptoms and/or laboratory parameters. Many clinicians report patients’ symptoms remarkably improved right before an unexpected and sudden deterioration. These unusual phenomena may be related to the human body’s remarkable capability to compensate for compromised respiratory function, which explains the improving symptomology observed while the virus-caused tissue damage continues. This highlights the urgent needs for measurable biomarkers that directly reflect the critical tissue damage occurring in patients.

Leveraging the collaborative power and intellectual infrastructure of the Center for Metabolomic Studies, we use a metabolomics approach, which can measure thousands of metabolites in biofluids, such as serum or urine, simultaneously to screen special tissue damage related biomarkers. Our laboratory has previously applied metabolomic analysis to biofluid samples collected from childhood pneumonia patients in West Africa to explore its potential to improve pneumonia diagnosis and prognosis. In this study, metabolomic results clearly distinguished severe pneumonia patients from community controls and provided potential insight into disease severity.

In the case of COVID-19, while the patient may not necessarily have clinical manifestations, tissue damage and consequent immune responses develop, which result in alterations in the level of metabolites in biofluids. We will meld our specialized techniques and knowledge to analyze blinded samples from COVID-19 patients with varying degrees of severity and differing clinical outcomes. In addition, we will also run longitudinal analysis from patients starting with similar mild symptoms but differing clinical progression as soon as samples are available.

These biomarkers associated with disease course and severity should help clinicians to distinguish patients who are likely to show abruptly worsened symptoms from the ones who are likely to recover, and the doctor can make proactive patient management accordingly. Such biomarkers can also help identify drugs that might work best against their biomarker targets.