High Expression Levels of miR-21-5p in Younger Hospitalized COVID-19 Patients Are Associated with Mortality and Critical Disease

Abstract

In COVID-19, critical disease and invasive mechanical ventilation (IMV) increase the risk of death, mainly in patients over 60 years of age. Objectives: To find the relationship between miR-21-5p and miR-146a-5p in terms of the severity, IMV, and mortality in hospitalized COVID-19 patients younger than 55 years of age. Methods: The patients were stratified according to disease severity using the IDSA/WHO criteria for severe and critical COVID-19 and subclassified into critical non-survivors and critical survivors. Results: Ninety-seven severe/critical COVID-19 patients were included; 81.3% of the deceased were male and 18.8% were female. Higher expression miR-21-5p levels were associated as follows: severe vs. critical disease (p = 0.007, FC = 0.498), PaO2/FiO2 index, mild vs. severe (p = 0.027, FC = 0.558), and survivors vs. non-survivors (p = 0.03, FC = 0.463). Moreover, we identified correlations with clinical variables: CRP (rho = −0.54, p < 0.001), D-dimer (rho = −0.47, p < 0.05), related to damage in the kidney (rho = 0.60, p < 0.001), liver (rho = 0.41, p < 0.05), and lung (rho = 0.54, p < 0.001). Finally, miR-21-5p thresholds were calculated according to severity (8.191), IMV (8.191), and mortality (8.237); these values increased the risk of developing a critical disease (OR = 4.19), the need for IMV (OR = 5.63), and death (OR = 6.00). Conclusion: Increased expression levels of miR-21-5p are related to worse outcome of COVID-19 in younger hospitalized patients.

Exosomes, and the potential for exosome‐based interventions against COVID‐19

“…For example, exosomal miRNAs, including miR-21, miR-155, and miR-146a, have been identified as possible diagnostic markers for COVID-19, with significantly higher levels in patients than healthy individuals. 186,187 Furthermore, exosomal miRNAs appear to be more stable and present at higher levels than free miRNAs in serum/plasma due to their encapsulation within exosomes, which protects them from degradation. Moreover, exosomal miRNAs might offer disease-specific and tissuespecific signatures, potentially allowing a refined diagnosis.…”

The Diagnostic and Predictive Value of Biomarkers for Pulmonary Fibrosis in Patients with Coronavirus Disease 2019

“…Oropharyngeal swab specimens were used for reverse transcriptase polymerase chain reaction and were confirmed positive when Ct ≤ 35.0. According to the severity of the disease using the Infection Disease Society of America[ 18 ] complemented with the WHO criteria,[ 19 ] patients were evaluated by specialist pulmonologists using clinical and laboratory criteria to stratify them in the following groups: moderate patients should have a persistent high fever for more than 3 days, along with coughing, feeling short of breath, etc., but a respiratory rate of <30 beats/min and an oxygen saturation of more than 94% on room air. Chest radiography revealed pneumonia or fibrosis symptoms typical with new coronavirus infections.…”