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Background The clinical course of COVID-19 patients ranges from asymptomatic infection, via mild and moderate illness, to severe disease and even fatal outcome. Biomarkers which enable an early prediction of the severity of COVID-19 progression, would be enormously beneficial to guide patient care and early intervention prior to hospitalization. Methods Here we describe the identification of plasma protein biomarkers using an antibody microarray-based approach in order to predict a severe cause of a COVID-19 disease already in an early phase of SARS-CoV-2 infection. To this end, plasma samples from two independent cohorts were analyzed by antibody microarrays targeting up to 998 different proteins. Results In total, we identified 11 promising protein biomarker candidates to predict disease severity during an early phase of COVID-19 infection coherently in both analyzed cohorts. A set of four (S100A8/A9, TSP1, FINC, IFNL1), and two sets of three proteins (S100A8/A9, TSP1, ERBB2 and S100A8/A9, TSP1, IFNL1) were selected using machine learning to identify a multimarker panel with sufficient accuracy for the implementation in a prognostic test. Conclusions Using these biomarkers, patients at high risk of developing a severe or critical disease course may be selected for treatment with specialized therapeutic options such as neutralizing antibodies or antivirals. Early therapy through early stratification may not only have a positive impact on the outcome of individual COVID-19 patients but could additionally prevent hospitals from being overwhelmed. This code was used for the machine learning subsection of the Materials & Methods section.
Proteomics, SARS-CoV-2, Viral infection, Protein array analysis, High-throughput screening, Biomarkers, Antibodies
Proteomics, SARS-CoV-2, Viral infection, Protein array analysis, High-throughput screening, Biomarkers, Antibodies
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