Circulating DNA levels linked to COVID-19 severity and respiratory support needs
Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 30, 2024 3 months, 3 weeks, 1 day, 16 hours, 30 minutes ago
COVID-19 News: As the COVID-19 pandemic continues to impact lives globally, researchers are constantly seeking new ways to predict and manage severe cases. A recent study conducted by researchers from Showa University Hospital in Tokyo, Japan, and Nara Medical University in Kashihara, Japan, has brought to light a potential biomarker that could help in early identification of patients who might require intensive respiratory support. This
COVID-19 News report delves into the findings that indicate how levels of circulating cell-free DNA (cfDNA) in the blood can predict the severity of respiratory failure in COVID-19 patients.
Circulating DNA levels linked to COVID-19 severity and respiratory support needs
The Study and Its Significance
Cell-free DNA (cfDNA), which is released from damaged cells, plays a significant role in aggravating inflammation. COVID-19, caused by the SARS-CoV-2 virus, often leads to severe respiratory issues, including pneumonia and acute respiratory distress syndrome (ARDS). These conditions necessitate oxygen therapy (OT) and sometimes mechanical ventilation (MV). The study hypothesized that elevated levels of cfDNA in the bloodstream could serve as a predictor for the need for OT or MV in COVID-19 patients.
The study involved analyzing serum samples from 95 hospitalized COVID-19 patients at Showa University Hospital. Researchers measured the copy numbers of mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) using quantitative real-time PCR (qPCR). The goal was to determine if these levels correlated with the severity of respiratory failure and the subsequent requirement for oxygen support.
Key Findings: cfDNA as a Predictor
-Correlation with Blood Oxygen Levels
One of the critical findings was the negative correlation between cfDNA levels and blood oxygen levels (SpO2). Specifically, both cf-nDNA and cf-mtDNA levels showed a significant negative correlation with the SpO2/FiO2 ratio, which adjusts blood oxygen levels for the fraction of inspired oxygen. This means that higher cfDNA levels were associated with lower oxygen levels in the blood, indicating more severe respiratory failure.
-Association with Oxygen Therapy and Mechanical Ventilation
The study found that elevated levels of both cf-nDNA and cf-mtDNA were significantly associated with the requirement for OT or MV during hospitalization. Patients who needed oxygen support had notably higher levels of cfDNA in their bloodstream compared to those who did not. Multivariate logistic regression analysis confirmed that cfDNA levels were independent risk factors for the necessity of OT and MV.
-Patient Demographics and Severity Categories
Patients were categorized based on the severity of their condition into moderate, severe, and critical groups. The critical group, which required intensive care and MV, exhibited the highest levels of cfDNA. Notably, the critical cases had significantly higher cf-nDNA levels (median: 630.6 cop
ies/µL) compared to moderate cases (median: 349.4 copies/µL).
-Biomarkers and Clinical Indicators
In addition to cfDNA, the study also examined other clinical biomarkers such as neutrophil counts, d-dimer, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP). It was found that cf-nDNA levels positively correlated with several of these markers, particularly neutrophil counts and d-dimer levels. This correlation underscores the potential of cfDNA to serve as a comprehensive marker reflecting both tissue injury and inflammatory response.
Implications for Clinical Practice
The implications of these findings are profound. By identifying cfDNA as an early biomarker, healthcare providers can potentially predict which COVID-19 patients are at greater risk of developing severe respiratory failure. This early prediction can guide timely interventions, such as the initiation of OT or MV, ultimately improving patient outcomes.
Conclusion: Towards Better Management of COVID-19
The study findings highlight the significant role of circulating cell-free DNA in predicting the severity of respiratory failure in COVID-19 patients. Elevated cfDNA levels, particularly cf-nDNA and cf-mtDNA, are strong indicators of the need for oxygen therapy and mechanical ventilation.
These findings, published in the peer-reviewed journal: Scientific Reports, pave the way for improved management and treatment strategies for COVID-19, potentially saving lives through early intervention.
https://www.nature.com/articles/s41598-024-68433-4
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