Evidence for the utility of cfDNA plasma concentrations to predict disease severity in COVID-19: a retrospective pilot study

Katharina Hoeter; Elmo Neuberger; Susanne Fischer; Manuel Herbst; Ema Juškevičiūtė; Kira Enders; Heidi Rossmann; Martin F Sprinzl; Perikles Simon; Marc Bodenstein; Michael Schaefer

doi:10.7717/peerj.16072

Evidence for the utility of cfDNA plasma concentrations to predict disease severity in COVID-19: a retrospective pilot study

PeerJ. 2023 Sep 18:11:e16072. doi: 10.7717/peerj.16072. eCollection 2023.

Authors

Affiliations

¹ Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
² Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes-Gutenberg Universität Mainz, Mainz, Germany.
³ Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
⁴ Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.
⁵ Institute of Clinical Chemistry and Laboratory Medicine, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
⁶ Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
⁷ Focus Program Translational Neurosciences (FTN), Johannes Gutenberg-University, Mainz, Germany.
⁸ Research Center for Immunotherapy, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.

Abstract

Background: COVID-19 is a worldwide pandemic caused by the highly infective SARS-CoV-2. There is a need for biomarkers not only for overall prognosis but also for predicting the response to treatments and thus for improvements in the clinical management of patients with COVID-19. Circulating cell-free DNA (cfDNA) has emerged as a promising biomarker in the assessment of various pathological conditions. The aim of this retrospective and observational pilot study was to investigate the range of cfDNA plasma concentrations in hospitalized COVID-19 patients during the first wave of SARS-CoV-2 infection, to relate them to established inflammatory parameters as a correlative biomarker for disease severity, and to compare them with plasma levels in a healthy control group.

Methods: Lithium-Heparin plasma samples were obtained from COVID-19 patients (n = 21) during hospitalization in the University Medical Centre of Mainz, Germany between March and June 2020, and the cfDNA concentrations were determined by quantitative PCR yielding amplicons of long interspersed nuclear elements (LINE-1). The cfDNA levels were compared with those of an uninfected control group (n = 19).

Results: Plasma cfDNA levels in COVID-19 patients ranged from 247.5 to 6,346.25 ng/ml and the mean concentration was 1,831 ± 1,388 ng/ml (± standard deviation), which was significantly different from the levels of the uninfected control group (p < 0.001). Regarding clinical complications, the highest correlation was found between cfDNA levels and the myositis (p = 0.049). In addition, cfDNA levels correlated with the "WHO clinical progression scale". D-Dimer and C-reactive protein (CRP) were the clinical laboratory parameters with the highest correlations with cfDNA levels.

Conclusion: The results of this observational pilot study show a wide range in cfDNA plasma concentrations in patients with COVID-19 during the first wave of infection and confirm that cfDNA plasma concentrations serve as a predictive biomarker of disease severity in COVID-19.

Keywords: COVID-19; Cell free DNA; Clinical outcome; Organ dysfunction; Sars-CoV-2.

Publication types

Observational Study

MeSH terms

COVID-19*
Cell-Free Nucleic Acids*
Humans
Lithium
Patient Acuity
Pilot Projects
Retrospective Studies
SARS-CoV-2 / genetics

Substances

Cell-Free Nucleic Acids
Lithium

Associated data

DRKS/DRKS00029389

Grants and funding

The authors received no funding for this work.