‘Striking’ finding: MicroRNA may predict COVID-19 mortality risk among people with cancer
Key takeaways:
- Researchers identified two microRNA that may help predict which patients with cancer are most likely to die of COVID-19.
- The findings may be translatable to other infectious diseases, such as influenza.
Researchers have identified two microRNA that may predict which individuals with cancer are at elevated risk for COVID-19-related death.
Low levels of hsa-miR-150-5p and hsa-miR-93-5p in COVID-19 risk-associated genomic regions (CORSAIR) are associated with COVID-19-related mortality, Simone Anfossi, PhD, assistant professor of translational molecular pathology at The University of Texas MD Anderson Cancer Center, and colleagues found.
“The correlation with outcome was striking for us,” Anfossi told Healio. “We were happy to find something that can predict the severity of the disease and the clinical outcome.”
Background and methods
Prior research showed individuals with cancer have more than double the risk for COVID-19 mortality as the general population.
Male sex, increased age and cancer type all have been identified as risk factors.
Genetic variants, including single nucleotide polymorphisms (SNPs), also have been linked to COVID-19 severity.
“We decided to see if there are some microRNA close by the SNPs region that may have some direct or indirect correlation,” Anfossi said.
Researchers evaluated blood samples from 218 people (54.6% men; 67% white) with cancer and COVID-19 treated at MD Anderson. Nearly half (46.8%) were aged 46 to 59 years.
Investigators also evaluated samples from 23 health care workers at Municipal Clinical Emergency Teaching Hospital in Romania who had been vaccinated against COVID-19.
Findings
Anfossi and colleagues identified 157 microRNA elevated at CORSAIR.
Of those, hsa-miR-150-5p had the had the highest expression in B and T lymphocytes, as well as natural killer cells.
Additionally, it had an association with sepsis, which has been linked with COVID-19 death; it can be found near a variant connected with SARS-CoV-2; and it is associated with interleukin-18 expression, which has been linked to COVID-19 aggressiveness.
Because of these data, researchers tested 18 of the 157 microRNA at CORSAIR, as well as five non-CORSAIR microRNA connected with sepsis.
They discovered individuals who died of COVID-19 had lower levels of hsa-miR-150-5p than those who survived (P < .0001) and those who died of causes other than COVID-19 (P = .0072).
Investigators also found individuals who died of COVID-19-related causes had lower levels of the sepsis-related microRNA hsa-miR-93-5p than those who survived (P = .0017) and those who died of causes other than COVID-19 (P = .0117).
“If you have two patients with the same cancer and the same COVID, the difference between the two patients was the level of these two microRNA,” Anfossi said. “Among patients who had higher levels of 150 and 93, the disease resolved and they didn’t have any issues. They didn't die because of COVID-19. Patients who had a very low level of these two microRNA were not able to resolve the infection. They developed the severe COVID condition and passed away directly because of COVID or because of the consequences.”
An analysis of vaccinated, healthy individuals yielded similar results.
“If you are protected by the vaccine and your immune system works, you have a higher level [of these two microRNA],” Anfossi said. “If you have a weak response of your immune system by the infection of SARS-CoV-2, these two microRNA are low.”
Anfossi and colleagues also discovered patients who tested negative for SARS-CoV-2 had lower levels of hsa-miR-92b-3p (P = .0059).
Anfossi described this result as “interesting” from a scientific perspective, but the COVID-19 test already identifies incidence.
Next steps
Researchers will continue to investigate the correlation between the proximity of microRNA to SNPs to see “if there is some genetic regulation or chromatin interaction with some promoter or some other element — a genetic element that regulates the expression of this microRNA — or if there is no mechanistic regulation,” Anfossi said.
They also want to evaluate these microRNA in patients who have other conditions — such as cardiovascular disease or diabetes — and other viral infections, such as influenza.
Anfossi said he is confident the investigation in other viral infections will yield similar results.
“It’s the result of the global activation of your immune system,” Anfossi said. It’s like an indicator that your immune system is working properly against the infectious disease.”
For more information:
Simone Anfossi, PhD, can be reached at sanfossi@mdanderson.org.
Collapse