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Blood transcriptome profiling of COVID-19 patients

As the COVID-19 pandemic continues, much has been learned about the SARS-CoV-2 virus and COVID-19. However, the host response to SARS-CoV-2 has not yet been fully delineated, hampering a precise approach to therapy. Blood transcriptome analysis of COVID-19 patients may be useful for diagnostic purposes or for predicting outcomes through different models, larger clinical cohorts, and vaccine trials in the near future.

The PAXgene Blood RNA Tube* and PAXgene Blood miRNA Kit* have exhibited their utility in recently conducted research on whole-blood transcriptomic host response to SARS-CoV-2 and other viral infections in comparison to healthy volunteers.

“As transcriptomic changes in blood outside the patient body occur within minutes after blood collection, stabilization of the original RNA profile is crucial for reliable and reproducible gene expression analysis,” says Kalle Guenther, Associate Director, R&D Blood Samples, PreAnalytiX. The system,* comprised of a blood collection tube and kit for extraction of total RNA, including small RNA such as miRNA, provides standardized methods from blood collection to isolation and purification of total RNA including miRNA. When used according to ISO 20186-1, the system helps to standardize the steps for venous whole blood cellular RNA examination in what is referred to as the pre-examination phase as part of the entire workflow from specimen collection to the cellular RNA examination.

The following studies demonstrate the utility of PAXgene products for research in the fight against COVID-19.

Whole-blood transcriptomic host response to SARS-CoV-2

The clinical presentations of the virus range from asymptomatic, mild respiratory tract infections  to severe cases with acute respiratory distress syndrome, respiratory failure, and death. Reports of a dysregulated immune system in severe cases calls for a comprehensive characterization and understanding of the changes in the immune system. In a recently published article, a group of researchers provide evidence for the use of whole blood transcriptomics to distinguish COVID-19 from other infections, and also to monitor and potentially predict disease outcomes. The study assists in dissecting molecular phenotypes and stratifying COVID-19 patients, along with supporting drug target prediction for specific subgroups of patients. In their study, the researchers used PAXgene Blood RNA Tubes to collect and stabilize whole blood RNA from donors, with RNA extraction using the PAXgene Blood miRNA Kit.

Clinical utility of blood-based tests using gene expression assay

Early and accurate identification of individuals with viral infections is crucial for clinical management and public health interventions. A team of Duke University health scientists have published an article identifying biomarkers that classify numerous viral infections across the clinical stages of disease. The research exhibits a potential new way to guide treatment, quarantine decisions, and other clinical and public health interventions in the setting of endemic and pandemic infectious diseases. The blood-based test uses a gene expression assay to correctly predict nine different respiratory viral infections — including influenza, enterovirus, adenovirus and coronaviruses known to cause common colds. It shows the body's genes responding to a pathogen before symptoms are present. In their research for detection of transcriptomic responses, they collected peripheral blood in PAXgene Blood RNA Tubes, and extracted total RNA using the PAXgene Blood miRNA Kit.

Multiomics study on cellular effects of SARS-CoV-2 infection

The pandemic spread of the potentially life-threatening disease COVID-19 requires a thorough understanding of the longitudinal dynamics of host responses. Understanding the basis for temporal resolution of cellular features associated with a severe disease trajectory will be a pre-requisite for finding disease outcome predictors. A group of scientists performed studies that demonstrated broad cellular effects of SARS-CoV-2 infection beyond classical immune cells and may serve as an entry point to develop biomarkers and targeted treatments of patients with COVID-19. The researchers collected blood in PAXgene Blood RNA Tubes, and extracted total RNA using the PAXgene Blood miRNA Kit.

* The PAXgene Blood RNA System is available for in vitro diagnostic (IVD) use only when the PAXgene Blood RNA Tube (Cat. No. 762165) is used in combination with the PAXgene Blood RNA Kit (Cat. No. 762164 or 762174). The PAXgene Blood miRNA Kit is available for research use only (RUO) (Cat. No. 763134).

For up-to-date licensing information and product-specific disclaimers, see the respective PreAnalytiX handbook or user manual. PreAnalytiX handbooks and user manuals are available at or can be requested from your local distributor.