High expression of oleoyl-ACP-hydrolase predicts mortality in patients hospitalized with avian A(H7N9) influenza

Although respiratory viral infections cause significant morbidity and mortality, it is still not fully clear why some individuals succumb to severe disease. In patients hospitalized with avian A(H7N9) influenza, we investigated early drivers underpinning hypercytokinemia and fatal disease. Our transcriptomics studies identified differential expression of 10 early host genes, defined by 16 probe sets, between patients who recovered and died. Seven probe sets were specific for the same host gene encoding for a key enzyme mediating free fatty acid production, oleoyl-ACP-hydrolase (OLAH). High olah transcript levels in fatal A(H7N9) patients were detected early after hospital admission and persisted until patients died. Conversely, patients who recovered had minimal olah transcript expression throughout their hospital stays. Blood samples were obtained from 8 patients hospitalized with avian A(H7N9) influenza, including 4 patients who survived and 4 who succumbed to disease during hospitalization. For 7 of these patients, we have paired samples obtained early after disease onset and late after disease onset. For 1 patient, data are only available for the late time point.