Early Prediction of COVID-19 Severity Using Extracellular Vesicles and Extracellular RNAs

Abstract

The clinical manifestations of COVID-19 vary broadly, ranging from asymptomatic infection to acute respiratory failure and death. But the predictive biomarkers for characterizing the variability are still lacking. Since emerging evidence indicates that extracellular vesicles (EVs) and extracellular RNAs (exRNAs) are functionally involved in a number of pathological processes, we hypothesize that these extracellular components may be key determinants and/or predictors of COVID-19 severity. To test our hypothesis, we collected serum samples from 31 patients with mild COVID-19 symptoms at the time of their admission. After standard therapy without corticosteroids, 9 of the 31 patients developed severe COVID-19 symptoms. We analyzed EV protein and exRNA profiles to look for correlations between these profiles and COVID-19 severity. Strikingly, we identified three distinct groups of markers (antiviral response-related EV proteins, coagulation-related markers, and liver damage-related exRNAs) with the potential to serve as early predictive biomarkers for COVID-19 severity. Among these markers, EV COPB2 has the best predictive value for severe deterioration of COVID-19 patients in this cohort. This type of information concerning functional extracellular component profiles could have great value for patient stratification and for making early clinical decisions about strategies for COVID-19 therapy.

Extracellular Vesicles: Versatile Nanomediators, Potential Biomarkers and Therapeutic Agents in Atherosclerosis and COVID-19-Related Thrombosis

“…They found that fibrinogen gamma chain (FGG), CD147, calpain 2 (CAPN2), extracellular matrix protein 1 (ECM1), coat complex subunit beta 2 (COPB2), KRAS proto-oncogene (KRAS), protein kinase C beta (PRKCB) and ras homolog family member C (RhoC) were significantly more abundant in SARS-COV-2 infected patients than in healthy donors. This group of markers can distinguish between severe and mild cases of COVID-19; among them, COPB2 has the best predictive value [ 147 ].…”

Extracellular Vesicle-Based Therapy for COVID-19: Promises, Challenges and Future Prospects

“…EVs are lipid bilayer membrane-bound structures, which are released from various kinds of cells, and contain many bioactive compounds (cargo) such as mRNAs, microRNAs (miRNAs), DNA, lipids, and various proteins. Due to their intact structure, EVs can circulate through body fluids freely and can deliver their cargo to neighboring or remote cells to help maintain their physiological condition [12].…”

Efficacy of mesenchymal stromal cells and cellular products in improvement of symptoms for COVID‐19 and similar lung diseases

“…All aspects of exosomes on treatment of COVID-19 or its related symptoms is discuses on reference: (Kadriyan et al, 2020,). EVs interestingly not only can be useful for treatment but also could predict the severity of COVID-19 (Fujita et al, 2020;Inal, 2020;Rosell et al, 2020). Khatri et al studied the effect of MSC-EVs on lung epithelial cells.…”