Dataset Information

A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study.

ABSTRACT:

Background

The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU.

Methods

This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group.

Results

Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR < 0.05). Cox regression analysis revealed that low expression levels of eight miRNAs were associated with a higher risk of death (HR from 1.56 to 2.61). LASSO regression for variable selection was used to construct a miRNA classifier. A 4-blood miRNA signature composed of miR-16-5p, miR-192-5p, miR-323a-3p and miR-451a predicts the risk of all-cause in-ICU mortality (HR 2.5). Kaplan‒Meier analysis confirmed these findings. The miRNA signature provides a significant increase in the prognostic capacity of conventional scores, APACHE-II (C-index 0.71, DeLong test p-value 0.055) and SOFA (C-index 0.67, DeLong test p-value 0.001), and a risk model based on clinical predictors (C-index 0.74, DeLong test-p-value 0.035). For 28-day and 90-day mortality, the classifier also improved the prognostic value of APACHE-II, SOFA and the clinical model. The association between the classifier and mortality persisted even after multivariable adjustment. The functional analysis reported biological pathways involved in SARS-CoV infection and inflammatory, fibrotic and transcriptional pathways.

Conclusions

A blood miRNA classifier improves the early prediction of fatal outcomes in critically ill COVID-19 patients.

SUBMITTER: de Gonzalo-Calvo D

PROVIDER: S-EPMC10276486 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study.

de Gonzalo-Calvo David D Molinero Marta M Benítez Iván D ID Perez-Pons Manel M García-Mateo Nadia N Ortega Alicia A Postigo Tamara T García-Hidalgo María C MC Belmonte Thalia T Rodríguez-Muñoz Carlos C González Jessica J Torres Gerard G Gort-Paniello Clara C Moncusí-Moix Anna A Estella Ángel Á Tamayo Lomas Luis L Martínez de la Gándara Amalia A Socias Lorenzo L Peñasco Yhivian Y de la Torre Maria Del Carmen MDC Bustamante-Munguira Elena E Gallego Curto Elena E Martínez Varela Ignacio I Martin Delgado María Cruz MC Vidal-Cortés Pablo P López Messa Juan J Pérez-García Felipe F Caballero Jesús J Añón José M JM Loza-Vázquez Ana A Carbonell Nieves N Marin-Corral Judith J Jorge García Ruth Noemí RN Barberà Carmen C Ceccato Adrián A Fernández-Barat Laia L Ferrer Ricard R Garcia-Gasulla Dario D Lorente-Balanza Jose Ángel JÁ Menéndez Rosario R Motos Ana A Peñuelas Oscar O Riera Jordi J Bermejo-Martin Jesús F JF Torres Antoni A Barbé Ferran F

Respiratory research 20230617 1

<h4>Background</h4>The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU.<h4>Methods</h4>This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU fr ...[more]

PMID: 37328754

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Project description:Background Since the beginning of coronavirus disease 2019 (COVID-19), the development of predictive models has sparked relevant interest due to the initial lack of knowledge about diagnosis, treatment, and prognosis. The present study aimed at developing a model, through a machine learning approach, to predict intensive care unit (ICU) mortality in COVID-19 patients based on predefined clinical parameters. Results Observational multicenter cohort study. All COVID-19 adult patients admitted to 25 ICUs belonging to the VENETO ICU network (February 28th 2020-april 4th 2021) were enrolled. Patients admitted to the ICUs before 4th March 2021 were used for model training (“training set”), while patients admitted after the 5th of March 2021 were used for external validation (“test set 1”). A further group of patients (“test set 2”), admitted to the ICU of IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, was used for external validation. A SuperLearner machine learning algorithm was applied for model development, and both internal and external validation was performed. Clinical variables available for the model were (i) age, gender, sequential organ failure assessment score, Charlson Comorbidity Index score (not adjusted for age), Palliative Performance Score; (ii) need of invasive mechanical ventilation, non-invasive mechanical ventilation, O2 therapy, vasoactive agents, extracorporeal membrane oxygenation, continuous venous-venous hemofiltration, tracheostomy, re-intubation, prone position during ICU stay; and (iii) re-admission in ICU. One thousand two hundred ninety-three (80%) patients were included in the “training set”, while 124 (8%) and 199 (12%) patients were included in the “test set 1” and “test set 2,” respectively. Three different predictive models were developed. Each model included different sets of clinical variables. The three models showed similar predictive performances, with a training balanced accuracy that ranged between 0.72 and 0.90, while the cross-validation performance ranged from 0.75 to 0.85. Age was the leading predictor for all the considered models. Conclusions Our study provides a useful and reliable tool, through a machine learning approach, for predicting ICU mortality in COVID-19 patients. In all the estimated models, age was the variable showing the most important impact on mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s44158-021-00002-x.

Project description:BACKGROUND:MicroRNAs (miRNAs) are approximately 22-nucleotide long regulatory RNA that mediate RNA interference by binding to cognate mRNA target regions. Here, we present a distributed kernel SVM-based binary classification scheme to predict miRNA targets. It captures the spatial profile of miRNA-mRNA interactions via smooth B-spline curves. This is accomplished separately for various input features, such as thermodynamic and sequence-based features. Further, we use a principled approach to uniformly model both canonical and non-canonical seed matches, using a novel seed enrichment metric. Finally, we verify our miRNA-mRNA pairings using an Elastic Net-based regression model on TCGA expression data for four cancer types to estimate the miRNAs that together regulate any given mRNA. RESULTS:We present a suite of algorithms for miRNA target prediction, under the banner Avishkar, with superior prediction performance over the competition. Specifically, our final kernel SVM model, with an Apache Spark backend, achieves an average true positive rate (TPR) of more than 75 percent, when keeping the false positive rate of 20 percent, for non-canonical human miRNA target sites. This is an improvement of over 150 percent in the TPR for non-canonical sites, over the best-in-class algorithm. We are able to achieve such superior performance by representing the thermodynamic and sequence profiles of miRNA-mRNA interaction as curves, devising a novel seed enrichment metric, and learning an ensemble of miRNA family-specific kernel SVM classifiers. We provide an easy-to-use system for large-scale interactive analysis and prediction of miRNA targets. All operations in our system, namely candidate set generation, feature generation and transformation, training, prediction, and computing performance metrics are fully distributed and are scalable. CONCLUSIONS:We have developed an efficient SVM-based model for miRNA target prediction using recent CLIP-seq data, demonstrating superior performance, evaluated using ROC curves for different species (human or mouse), or different target types (canonical or non-canonical). We analyzed the agreement between the target pairings using CLIP-seq data and using expression data from four cancer types. To the best of our knowledge, we provide the first distributed framework for miRNA target prediction based on Apache Hadoop and Spark. AVAILABILITY:All source code and sample data are publicly available at https://bitbucket.org/cellsandmachines/avishkar. Our scalable implementation of kernel SVM using Apache Spark, which can be used to solve large-scale non-linear binary classification problems, is available at https://bitbucket.org/cellsandmachines/kernelsvmspark.

Dataset Information

A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study.

Background

Methods

Results

Conclusions

Publications

A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study.

Similar Datasets

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