A Digital Protein Microarray for COVID-19 Cytokine Storm Monitoring.
Yujing SongYuxuan YeShiuan-Haur SuAndrew StephensTao CaiMeng Ting ChungMeilan K HanMichael W NewsteadDavid FrameBenjamin H SingerKatsuo KurabayashiPublished in: medRxiv : the preprint server for health sciences (2020)
Despite widespread concern for cytokine storms leading to severe morbidity in COVID-19, rapid cytokine assays are not routinely available for monitoring critically ill patients. We report the clinical application of a machine learning-based digital protein microarray platform for rapid multiplex quantification of cytokines from critically ill COVID-19 patients admitted to the intensive care unit (ICU) at the University of Michigan Hospital. The platform comprises two low-cost modules: (i) a semi-automated fluidic dispensing/mixing module that can be operated inside a biosafety cabinet to minimize the exposure of technician to the virus infection and (ii) a 12-12-15 inch compact fluorescence optical scanner for the potential near-bedside readout. The platform enabled daily cytokine analysis in clinical practice with high sensitivity (<0.4pg/mL), inter-assay repeatability (~10% CV), and near-real-time operation with a 10 min assay incubation. A cytokine profiling test with the platform allowed us to observe clear interleukin-6 (IL-6) elevations after receiving tocilizumab (IL-6 inhibitor) while significant cytokine profile variability exists across all critically ill COVID-19 patients and to discover a weak correlation between IL-6 to clinical biomarkers, such as Ferritin and CRP. Our data revealed large subject-to-subject variability in a patient's response to anti-inflammatory treatment for COVID-19, reaffirming the need for a personalized strategy guided by rapid cytokine assays.
Keyphrases
- high throughput
- sars cov
- coronavirus disease
- machine learning
- low cost
- single cell
- clinical practice
- healthcare
- rheumatoid arthritis
- emergency department
- intensive care unit
- respiratory syndrome coronavirus
- early onset
- systemic lupus erythematosus
- risk assessment
- high resolution
- climate change
- electronic health record
- artificial intelligence
- loop mediated isothermal amplification
- magnetic resonance
- big data
- amino acid
- mass spectrometry
- combination therapy
- mechanical ventilation
- disease activity
- juvenile idiopathic arthritis