Altered microRNA expression in COVID-19 patients enables identification of SARS-CoV-2 infection.

• Main Authors: Ryan J Farr, Christina L Rootes, Louise C Rowntree, Thi H O Nguyen, Luca Hensen, Lukasz Kedzierski, Allen C Cheng, Katherine Kedzierska, Gough G Au, Glenn A Marsh, Seshadri S Vasan, Chwan Hong Foo, Christopher Cowled, Cameron R Stewart
• Format: Article
• Language: English
• Published: Public Library of Science (PLoS) 2021-07-01
• Series: PLoS Pathogens
• Online Access: https://doi.org/10.1371/journal.ppat.1009759

The host response to SARS-CoV-2 infection provide insights into both viral pathogenesis and patient management. The host-encoded microRNA (miRNA) response to SARS-CoV-2 infection, however, remains poorly defined. Here we profiled circulating miRNAs from ten COVID-19 patients sampled longitudinally and ten age and gender matched healthy donors. We observed 55 miRNAs that were altered in COVID-19 patients during early-stage disease, with the inflammatory miR-31-5p the most strongly upregulated. Supervised machine learning analysis revealed that a three-miRNA signature (miR-423-5p, miR-23a-3p and miR-195-5p) independently classified COVID-19 cases with an accuracy of 99.9%. In a ferret COVID-19 model, the three-miRNA signature again detected SARS-CoV-2 infection with 99.7% accuracy, and distinguished SARS-CoV-2 infection from influenza A (H1N1) infection and healthy controls with 95% accuracy. Distinct miRNA profiles were also observed in COVID-19 patients requiring oxygenation. This study demonstrates that SARS-CoV-2 infection induces a robust host miRNA response that could improve COVID-19 detection and patient management.