Temporal associations of plasma levels of the secreted phospholipase A 2 family and mortality in severe COVID-19

Previous research suggests that group IIA-secreted phospholipase A (sPLA -IIA) plays a role in and predicts lethal COVID-19 disease. The current study reanalyzed a longitudinal proteomic data set to determine the temporal relationship between levels of several members of a family of sPLA isoforms and the severity of COVID-19 in 214 ICU patients. The levels of six secreted PLA isoforms, sPLA -IIA, sPLA -V, sPLA -X, sPLA -IB, sPLA -IIC, and sPLA -XVI, increased over the first 7 ICU days in those who succumbed to the disease but attenuated over the same time period in survivors. In contrast, a reversed pattern in sPLA -IID and sPLA -XIIB levels over 7 days suggests a protective role of these two isoforms. Furthermore, decision tree models demonstrated that sPLA -IIA outperformed top-ranked cytokines and chemokines as a predictor of patient outcome. Taken together, proteomic analysis revealed temporal sPLA patterns that reflect the critical roles of sPLA isoforms in severe COVID-19 disease.