Scientists at the University of Washington School of Medicine in St. Louis have found a way to determine which patients with COVID-19 are at high risk for complications. This is reported in an article available in the bioRxiv preprint repository and accepted for publication in JCI Insight.
The study involved 97 patients infected with the SARS-CoV-2 coronavirus, from whom blood plasma was taken to detect freely circulating mitochondrial DNA (mtDNA). mtDNA serves as an indicator of cell death caused by viral infection and severe immune system reactions, and belongs to the so-called damage associated molecular patterns (DAMPs). It has been shown that the level of mtDNA sharply increases during sepsis, hemorrhagic shock and ischemia.
It turned out that the level of mitochondrial DNA was high in patients who were eventually admitted to the intensive care unit, and also had a high risk of early death. This relationship does not depend on the age, gender of the patient, or chronic diseases. On average, mtDNA levels were 10 times higher in those who developed severe lung dysfunction or who died from complications. The increase in the amount of mtDNA increased the risk of intubation sixfold, intensive care – threefold, and death – twofold.
The mitochondrial DNA test was better at predicting the condition of patients than tests for other markers that indicate systemic inflammation. mtDNA exhibits an inflammation specific to cell death and is life-threatening for the patient. In addition, the test does not require complex and expensive equipment and can be performed as easily and quickly as PCR analysis. However, it is still worth conducting a larger test of the method before getting FDA approval.
