Clinical, molecular, and functional biomarkers for prognosis, pathomechanisms, and treatment strategies in COVID-19

clinical trial - Infections with the novel Severe Acute Respiratory Syndrome - Coronavirus-2 (SARS-CoV-2) manifest with a broad spectrum of clinical presentations, ranging from asymptomatic to upper respiratory tract infections, uncomplicated pneumonia and severe pneumonia with respiratory failure and high lethality. Despite more than 1 Mio. documented infections worldwide, a profound lack of knowledge impedes clinical management and the development of therapies. COVID-19-associated pneumonia and lung injury differ in relevant details from any of the known types of pneumonia that cause respiratory failure, including viral infections like influenza or MERS-CoV. It is unclear whether specific decision guidelines established for pneumonia are applicable or whether these need to be refined for COVID-19. The PROVID consortium thus aims to characterize the host- and virus-dependent mechanisms associated with clinical appearance of COVID-19 to improve patient care through advances in risk stratification and clinical management. We will test the hypotheses that i) host factors (transcriptional response, proteins, antibodies) determine the severity and/or course of COVID-19, ii) molecular and clinical determinants of COVID-19 differ from those previously deciphered in other types of pneumonia and they can be used as molecular predictors for disease progression, iii) specific molecular markers of disease severity can be tested as therapeutic targets for COVID-19, iv) stabilization of barrier function - in addition to antivirals and immunomodulators - may present a third pillar for effective therapy.