Urine Proteome of COVID-19 Patients

The atypical pneumonia (COVID-19) caused by SARS-CoV-2 is an ongoing pandemic and a serious threat to global public health. The COVID-19 patients with severe symptoms account for a majority of mortality of this disease. However, early detection and effective prediction of patients with mild to severe symptoms remains challenging. In this study, we performed proteomic profiling of urine samples from 32 healthy control individuals and 6 COVID-19 positive patients (3 mild and 3 severe). We found that urine proteome samples from the mild and severe COVID-19 patients with comorbidities can be clearly differentiated from healthy proteome samples based on the clustering analysis. Multiple pathways have been compromised after the COVID-19 infection, including the dysregulation of immune response, complement activation, platelet degranulation, lipoprotein metabolic process and response to hypoxia. We further validated our finding by directly comparing the same patients’ urine proteome after recovery. This study demonstrates the COVID-19 pathophysiology related molecular alterations could be detected in the urine and the potential application of urinary proteome in auxiliary diagnosis, severity determination and therapy development of COVID-19. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by the MOST (2017YFC0906600 & 2017YFA0505002), the National Natural Science Foundation of China (31700723, 31670834, 31870824, 91839302 & 31901037), the Innovation Foundation of Medicine (16CXZ027, BWS17J032, AWS17J008 & 19SWAQ17), National Megaprojects for Key Infectious Diseases (2018ZX10302302), the Foundation of State Key Lab of Proteomics (SKLP-K201704), and the grant for Research Unit of Proteomics & Research and Development of New Drug of Chinese Academy of Medical Sciences (2019RU006). ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The accession numbers for the mass spectrometry proteomics data reported in this paper are the iProX () dataset identifier: IPX0002166000. All the data will be publicly released upon publication.