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Sci Rep . Role of immune-inflammatory biomarkers and their derived ratio in predicting COVID-19 severity and mortality

tetano

Editor, Senior Moderator
Sci Rep


. 2025 Nov 7;15(1):39003.
doi: 10.1038/s41598-025-24173-7. Role of immune-inflammatory biomarkers and their derived ratio in predicting COVID-19 severity and mortality

Sara I Taha[SUP] 1 [/SUP], Shaimaa H Fouad[SUP] 2 [/SUP], Eman M El-Sehsah[SUP] 3 [/SUP], Mahmoud Mokhtar Mohamed[SUP] 4 [/SUP], Azza Omran[SUP] 5 [/SUP], Marwa Hamdy[SUP] 6 7 [/SUP], Dalia Hussein Helmy Elsheikh[SUP] 8 [/SUP], Basim Othman[SUP] 9 [/SUP], Raed A Alharbi[SUP] 10 [/SUP], Rasha Ahmed Ghorab[SUP] 11 [/SUP]



Affiliations
Abstract

The pathogenesis of the coronavirus disease 2019 (COVID-19) involves a complex group of cytokines and is significantly influenced by genetic and epigenetic factors. The current study aims to assess the association of COVID-19 severity and mortality with the relative expression of MicroRNA-155 (miR-155) and its association with serum levels of interleukin (IL)-6, IL-10, and their derived ratio. This pilot case-control study included 75 COVID-19 patients and 25 healthy controls. Serum levels of cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA), and assessment of miR-155 relative expression level was done using quantitative real-time PCR in all participants. We found that IL-6, IL-10, IL-6/IL-10 ratio, and miR-155 expression levels were significantly higher in COVID-19 patients than in healthy controls (p-values < 0.001). The expression level of miR-155 showed significant differences between all severity categories of COVID-19, reaching its highest levels in the severe group. It was also significantly higher in ICU-admitted patients (p-value < 0.001) and those who died during their hospital stay (p-value = 0.001). It showed a significant negative correlation with serum IL-10 (r=-0.249, p-value = 0.031) and a significant positive correlation with IL-6/IL-10 ratio (r = 0.234, p-value = 0.043). It was also the only independent risk factor for COVID-19 severity by regression analysis and the best predictor for COVID-19 severity by ROC curve analysis. This study reported elevation of cytokines and miR-155 expression in COVID-19 patients. The level of miR-155 expression was associated with COVID-19 severity, mortality, and ICU admission, indicating its potential utility as a biomarker for monitoring the progression of COVID-19 and guiding patient follow-up.

Keywords: COVID-19; Cytokine storm; MiR-155; Mortality; Severity.

 
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