Temporal associations of plasma levels of the secreted phospholipase A₂ family and mortality in severe COVID-19

Previous research suggests that group IIA-secreted phospholipase A(2) (sPLA(2)-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(2) isoforms and the severity of COVID-19 in 214 ICU patients. The levels of six secreted PLA(2) isoforms, sPLA(2)-IIA, sPLA(2)-V, sPLA(2)-X, sPLA(2)-IB, sPLA(2)-IIC, and sPLA(2)-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(2)-IID and sPLA(2)-XIIB levels over 7 days suggests a protective role of these two isoforms. Furthermore, decision tree models demonstrated that sPLA(2)-IIA outperformed top-ranked cytokines and chemokines as a predictor of patient outcome. Taken together, proteomic analysis revealed temporal sPLA(2) patterns that reflect the critical roles of sPLA(2) isoforms in severe COVID-19 disease.