Serum TGFβ as a predictive biomarker for severe disease and fatality of COVID-19.

Abstract

For targeted intervention in COVID-19, there is a high medical need for biomarkers that predict disease progression and severity in the first days after symptom onset. This study assessed the utility of early transforming growth factor β (TGFβ) serum levels in COVID-19 patients to predict disease severity, fatality, and response to dexamethasone therapy. Patients with severe COVID-19 had significantly higher TGFβ levels (416 pg/ml) as compared to patients with mild (165 pg/ml, p<0.0001) or moderate COVID-19 (241 pg/ml; p<0.0001). Receiver operating characteristics area under the curve values were 0.92 (95% confidence interval [CI] 0.85 - 0.99, cut-off: 255 pg/ml) for mild versus severe COVID-19, and 0.83 (95% CI 0.65-1.0, cut-off: 202 pg/ml) for moderate versus severe COVID-19. Patients who died of severe COVID-19 had significantly higher TGFβ levels (453 pg/ml) as compared to convalescent patients (344 pg/ml), and TGFβ levels predicted fatality (AUC: 0.75, 95% CI 0.53 - 0.96). TGFβ was significantly reduced in severely ill patients treated with dexamethasone (301 pg/ml) as compared to untreated patients (416 pg/ml; p<0.05). Early TGFβ serum levels in COVID-19 patients predict, with high accuracy, disease severity, and fatality. In addition, TGFß serves as a specific biomarker to assess response to dexamethasone treatment. This article is protected by copyright. All rights reserved.