AUTHOR=Teng Xiangyun , Zhang Jiaqi , Shi Yaling , Liu Yuntao , Yang Yanqing , He Jinyong , Luo Shuhong , Huang Yile , Liu Yanxia , Liu Dongdong , Li Yizhe , Zhang Shuangzhe , Huang Ruo-Pan , Wang Dawei , Xu Jianhua 

TITLE=Comprehensive Profiling of Inflammatory Factors Revealed That Growth Differentiation Factor-15 Is an Indicator of Disease Severity in COVID-19 Patients

JOURNAL=Frontiers in Immunology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.662465

DOI=10.3389/fimmu.2021.662465

ISSN=1664-3224

ABSTRACT=To systematically explore the biomarker which can predict the severity in COVID-19 patients and prevent the occurrence or development of severity in COVID-19 patients, the level of 440 severity associated factors were analyzed in asymptomatic, mild, moderate, severe, convalescent and healthy control group (categorized according to COVID-19 disease severity) groups. Factor candidates were validated by ELISA and functional relevance was uncovered by bioinformatics analysis. To identify the biomarker during the occurrence or development of COVID-19, patient sera from three different severity groups (moderate, severe, critical) at three time points (admission, remission, and discharge) were collected to measure the level of indicator candidates. Eleven differential cytokines associated with disease severity were pinpointed from 111 patients with different severity, the dynamic changes of GDF-15 reflect the progression of the disease, while the other factors include TRAIL R1, IGFBP-1, IGFBP-4, VCAM-1, sFRP-3, FABP2, Transferrin, GDF-15, IL-1 F7, IL-5 Ra, CD200. Elevation of white blood cell count, neutrophil count, Neutrophil-Lymphocyte Ratio (NLR), Alanine aminotransferase and Aspartate aminotransferase, low lymphocyte and eosinophil counts in the severe group were associated with the severity of COVID-19. GDF15 levels were observed to be associated with the severity of COVID-19 and the dynamic change of GDF15 levels was closely associated with the disease progression of COVID-19. Therefore, GDF15 might serve as an indicator of disease severity in COVID-19 patients.