Abstract
Objective:
Numerous biomarkers of COVID-19 severity have been studied recently, while their relevance in the post-COVID-19 era requires further validation. This study sought to identify reliable biomarkers within a single cohort through a comprehensive comparative analysis and to investigate the underlying molecular mechanisms.
Material and methods:
In this prospective, observational cohort study, we comprehensively assessed 41 markers in 97 COVID-19 pneumonia patients and 53 healthy volunteers. Receiver operating characteristics and Kaplan-Meier curves were plotted to determine the predictive value of effective biomarkers. Subsequently, flow cytometry, immunofluorescence, and Western blot analysis were conducted to evaluate the inflammatory cell death induced by the identified biomarkers in peripheral blood cells.
Results:
Based on the screening, plasma IL-6, IL-8, IL-10, IFN-α, PCT, and CRP at hospital admission were highly associated with disease severity (P < 0.001). A pairwise combination of CRP, PCT, and IFN-α could induce PANoptosis in neutrophils, lymphocytes, and platelets.
Conclusion:
The value of IL-6, IL-8, IL-10, IFN-α, PCT, and CRP in predicting the severity of COVID-19 was further verified in our study, and superior to novel biomarkers. Our data confirmed for the first time that CRP, PCT, and/or IFN-α triggers PANoptosis in lymphocytes, neutrophils, and platelets, which may prompt severe progression in COVID-19 patients.