COVID-19 primarily affects the lungs, but evidence of systemic disease with multi-organ involvement is emerging. Here, we developed a blood test to broadly quantify cell, tissue, and organ specific injury due to COVID-19, using genome-wide methylation profiling of circulating cell-free DNA in plasma. We assessed the utility of this test to identify subjects with severe disease in two independent, longitudinal cohorts of hospitalized patients. Cell-free DNA profiling was performed on 104 plasma samples from 33 COVID-19 patients and compared to samples from patients with other viral infections and healthy controls. We found evidence of injury to the lung and liver and involvement of red blood cell progenitors associated with severe COVID-19. The concentration of cfDNA correlated with the WHO ordinal scale for disease progression and was significantly increased in patients requiring intubation. This study points to the utility of cell-free DNA as an analyte to monitor and study COVID-19.

中文翻译：

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血液中无细胞的DNA显示出明显的细胞，组织和器官特异性损伤，并预测COVID-19的严重程度。

COVID-19主要影响肺部，但正在出现多器官受累的全身性疾病的证据。在这里，我们使用血浆中循环的无细胞DNA的全基因组甲基化谱图，开发了一项血液测试，以广泛量化因COVID-19引起的细胞，组织和器官特异性损伤。我们评估了该测试在两个独立的纵向住院患者队列中确定患有严重疾病的受试者的效用。对来自33名COVID-19患者的104个血浆样品进行无细胞DNA谱分析，并将其与患有其他病毒感染和健康对照的患者的样品进行比较。我们发现了严重的肺和肝损伤的证据以及与严重COVID-19相关的红细胞祖细胞的参与。cfDNA的浓度与WHO用于疾病进展的序数相关，并且在需要插管的患者中明显增加。这项研究指出了无细胞DNA作为监测和研究COVID-19的分析物的实用性。