Evidence map›Paper›PMID 40985719›Full record

ArticleJournal of virology2025

Prediction of COVID-19 disease progression by multiparametric analysis of circulating extracellular vesicles with flow cytometry.

Evelyn Hammer, Charlotte Flynn, Johannes Rößler, Johanna Erder, Rudolf Napieralski, Lisa Fricke, Birgit Campbell, Martin Feuerherd, Felix Esslinger, Albrecht von Brunn and 17 more

Abstract read
In one paragraph

Article in Journal of virology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Evelyn HammerInstitute of Molecular Immunology, University Hospital München rechts der Isar, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany.ORCID 0000-0003-2241-9446
Charlotte FlynnInstitute of Molecular Immunology, University Hospital München rechts der Isar, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany.
Johannes RößlerResearch Unit Gene Vectors, Helmholtz Zentrum München, Munich, Germany.ORCID 0000-0001-8097-2755
Johanna ErderTUM School of Medicine and Health, Department of Clinical Medicine - Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Munich, Germany.
Rudolf Napieralskitherawis diagnostics GmbH, Munich, Germany.
Lisa FrickeTUM School of Medicine and Health, Department of Clinical Medicine - Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Munich, Germany.
Birgit CampbellMedical Department - Molecular Cardiology, Technische Universität München, Munich, Germany.
Martin FeuerherdInstitute of Virology, Technische Universität München/Helmholtz Zentrum München, Munich, Germany.
Felix EsslingerInstitute of Virology, Technische Universität München/Helmholtz Zentrum München, Munich, Germany.
Albrecht von BrunnMax von Pettenkofer-Institut, Ludwig-Maximilians-Universität München, Munich, Germany.
Timm WeberLaboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Siobhan KingOxford Nanoimaging ONI, Oxford, United Kingdom.
Sisareuth TanUMR-5248 CBMN CNRS-University of Bordeaux-IPB, Allée Geoffroy Saint-Hilaire, Pessac, France.
Alain R BrissonGerman Centre for Infection Research (DZIF), Munich, Germany.
Ulrike ProtzerInstitute of Virology, Technische Universität München/Helmholtz Zentrum München, Munich, Germany.ORCID 0000-0002-9421-1911
Gabriele Schrickertherawis diagnostics GmbH, Munich, Germany.
Kathrin GärtnerEximmium Biotechnologies GmbH, Munich, Germany.
Gregor EbertInstitute of Virology, Technische Universität München/Helmholtz Zentrum München, Munich, Germany.
Allessandra MorettiMedical Department - Molecular Cardiology, Technische Universität München, Munich, Germany.
Florian KleinMax von Pettenkofer-Institut, Ludwig-Maximilians-Universität München, Munich, Germany.
Kevin KnoopsThe Microscopy CORE Lab, Maastricht Multimodal Molecular Imaging Institute, Maastricht University, Maastricht, the Netherlands.
Ron HeerenThe Microscopy CORE Lab, Maastricht Multimodal Molecular Imaging Institute, Maastricht University, Maastricht, the Netherlands.
Wolfgang HammerschmidtResearch Unit Gene Vectors, Helmholtz Zentrum München, Munich, Germany.ORCID 0000-0002-4659-0427
Reinhard ZeidlerResearch Unit Gene Vectors, Helmholtz Zentrum München, Munich, Germany.
Olaf Wilhelmtherawis diagnostics GmbH, Munich, Germany.
Percy A KnolleInstitute of Molecular Immunology, University Hospital München rechts der Isar, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany.ORCID 0000-0003-2983-0414
Bastian HöchstInstitute of Molecular Immunology, University Hospital München rechts der Isar, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany.ORCID 0000-0002-5567-1173

Funding

Corona Research Projects of the Free State of BavariaDFG SFB TRR179
6 · The paper itself

Abstract

Extracellular vesicles (EVs) are released from all cells of the body. They are considered to mirror the state of the cells from which they are released and circulate in the blood, suggesting a possible use of EV analysis for diagnostic purposes. Here, we report that the analysis of single EVs by flow cytometry can detect infection of cells with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by identifying expression of the SARS-CoV-2 spike (S) protein on the surface of EVs and the cellular origin of EVs by detecting cell-type-specific markers such as troponin (cTNT1) for cardiomyocytes. In coronavirus-associated disease 19 (COVID-19) patients, we detected a direct correlation of the frequencies of circulating S-expressing EVs, but not of cTNT/S-co-expressing EVs, with the subsequent development of a severe disease course. Detection of circulating S-expressing EVs indicates widespread SARS-CoV-2 infection in the body, which may contribute to the immune pathogenesis that triggers tissue and organ damage in COVID-19. Our findings suggest that detecting circulating viral antigen-expressing EVs may provide crucial predictive information on infection-associated disease courses in situations of a future viral pandemic.IMPORTANCEThe ability to predict which patients infected with the SARS-CoV-2 virus will develop severe disease remains a significant clinical challenge. The present study demonstrates that EVs in the peripheral blood, carrying the SARS-CoV-2 spike protein, can be detected by flow cytometry and serve as early biomarkers of disease progression. In contradistinction to PCR or serology, this method provides insight into systemic viral spread and potential organ involvement. The early identification of spike-positive EVs at the time of hospital admission has the potential to facilitate the timely identification of high-risk patients, thereby enhancing the efficacy of triage and subsequent care. This approach may also be of value in terms of facilitating a more rapid and precise response to future virus pandemics.

Indexed as

COVID-19Extracellular VesiclesFlow CytometrySARS-CoV-2AgedBiomarkersDisease ProgressionFemaleHumansMaleMiddle AgedSpike Glycoprotein, CoronavirusBiomarkersSpike Glycoprotein, Coronavirusspike protein, SARS-CoV-2COVID-19extracellular vesiclesflow cytometryprogress predictionSARS-CoV2virosome

Identifiers

PMID40985719
PMCPMC12548395

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.