Biomarkers of COVID-19 severity may not serve patients with polycystic ovary syndrome

In a cohort of patients with differing severity of COVID-19 disease, including non-survivors, plasma proteomic analysis identified biomarkers of COVID-19 disease progression. The top pathways identified by Shu et al. were those of platelet degranulation and the complement and coagulation cascades. These identified pathways were complementary to another recent study comparing COVID-19 disease and control subjects, where proteomic panels also identified biological pathways involved in platelet degranulation and the coagulation cascade. Whilst the comparison with absolute disease-free normality is relevant, an increasing proportion of the population have insulin resistant states with associated metabolic conditions; an example of such a metabolic condition is polycystic ovary syndrome (PCOS) where it has been shown that protein expression patterns may differ compared to those without PCOS. Notably, in PCOS, platelet aggregation enhancement together with aberrant diminished plasma fibrinolytic activity potentially giving rise to enhanced thrombosis has been described, with markers of coagulation being enhanced.