Purpose COVID-19 MESHD
has impacted millions of patients across the world. Molecular testing occurring now identifies the presence of the virus at the sampling site: nasopharynx, nares, or oral cavity. RNA sequencing has the potential to establish both the presence of the virus and define the hosts response in COVID-19 MESHD
MethodsSingle center, prospective study of patients with COVID-19 MESHD
admitted to the intensive care unit where deep RNA sequencing (>100 million reads) of peripheral blood with computational biology analysis was done. All patients had positive SARS-CoV-2 PCR. Clinical data was prospectively collected.
ResultsWe enrolled fifteen patients at a single hospital. Patients were critically ill with a mortality of 47% and 67% were on a ventilator. All the patients had the SARS-CoV- MESHD
2 RNA identified in the blood in addition to RNA from other viruses, bacteria, and archaea. The expression of many immune modulating genes, including PD-L1 HGNC
and PD-L2 HGNC
, were significantly different in patients who died from COVID-19 MESHD
. Some proteins were influenced by alternative transcription and splicing events, as seen in HLA-C, HLA-E HGNC
, NRP1 HGNC
and NRP2 HGNC
. Entropy calculated from alternative RNA splicing and transcription start/end predicted mortality in these patients.
ConclusionsCurrent upper respiratory tract testing for COVID-19 MESHD
only determines if the virus is present. Deep RNA sequencing with appropriate computational biology may provide important prognostic information and point to therapeutic foci to be precisely targeted in future studies.
Take Home MessageDeep RNA sequencing provides a novel diagnostic tool for critically ill MESHD
patients. Among ICU patients with COVID-19 MESHD
, RNA sequencings can identify gene expression, pathogens (including SARS-CoV-2), and can predict mortality.
TweetDeep RNA sequencing is a novel technology that can assist in the care of critically ill COVID-19 MESHD
patients & can be applied to other disease