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

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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.