Serum TGF‐β as a predictive biomarker for severe disease and fatality of COVID‐19
Stefan Frischbutter, Pawel Durek, Mario Witkowski, Stefan Angermair, Sascha Treskatsch, Marcus Maurer, Andreas Radbruch, Mir‐Farzin Mashreghi
Abstract
For targeted intervention in coronavirus disease 2019 (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 (TGF-β) serum levels in COVID-19 patients to predict disease severity, fatality, and response to dexamethasone therapy. Patients with severe COVID-19 had significantly higher TGF-β 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 TGF-β levels (453 pg/mL) as compared to convalescent patients (344 pg/mL), and TGF-β levels predicted fatality (area under the curve: 0.75, 95% CI 0.53-0.96). TGF-β 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 TGF-β serum levels in COVID-19 patients predict, with high accuracy, disease severity, and fatality. In addition, TGF-β serves as a specific biomarker to assess response to dexamethasone treatment.