Macrophage expression and prognostic significance of the long pentraxin PTX3 in COVID-19

Nat Immunol. 2021 Jan;22(1):19-24. doi: 10.1038/s41590-020-00832-x. Epub 2020 Nov 18.


Long pentraxin 3 (PTX3) is an essential component of humoral innate immunity, involved in resistance to selected pathogens and in the regulation of inflammation1-3. The present study was designed to assess the presence and significance of PTX3 in Coronavirus Disease 2019 (COVID-19)4-7. RNA-sequencing analysis of peripheral blood mononuclear cells, single-cell bioinformatics analysis and immunohistochemistry of lung autopsy samples revealed that myelomonocytic cells and endothelial cells express high levels of PTX3 in patients with COVID-19. Increased plasma concentrations of PTX3 were detected in 96 patients with COVID-19. PTX3 emerged as a strong independent predictor of 28-d mortality in multivariable analysis, better than conventional markers of inflammation, in hospitalized patients with COVID-19. The prognostic significance of PTX3 abundance for mortality was confirmed in a second independent cohort (54 patients). Thus, circulating and lung myelomonocytic cells and endothelial cells are a major source of PTX3, and PTX3 plasma concentration can serve as an independent strong prognostic indicator of short-term mortality in COVID-19.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • A549 Cells
  • Adult
  • C-Reactive Protein / genetics*
  • C-Reactive Protein / metabolism
  • COVID-19 / epidemiology
  • COVID-19 / genetics*
  • COVID-19 / virology
  • Cell Line, Tumor
  • Cells, Cultured
  • Cohort Studies
  • Endothelial Cells / metabolism
  • Epidemics
  • Female
  • Gene Expression Profiling / methods*
  • Humans
  • Macrophages / metabolism*
  • Male
  • Middle Aged
  • Monocytes / metabolism
  • Neutrophils / metabolism
  • Prognosis
  • SARS-CoV-2 / isolation & purification*
  • SARS-CoV-2 / physiology
  • Serum Amyloid P-Component / genetics*
  • Serum Amyloid P-Component / metabolism


  • Serum Amyloid P-Component
  • PTX3 protein
  • C-Reactive Protein