Document Type

Journal Article

Publication Title

Frontiers in Immunology



PubMed ID





School of Science




Research Grant, and a US Department of Defence – Breast Cancer Research Program – breakthrough award level 1 (#BC200025)

Lion Medical Research Foundation (2015001964)

Agencia Nacional de Investigación y Desarrollo (COVID1005-ANID)

Centre of Research Excellence in Emerging Infectious Diseases (CREID; MS, BT)

National Health and Medical Research Council of Australia

Priority driven Collaborative Cancer Research Scheme, funded by Cure Cancer Australia with the assistance of Cancer Australia and the Can Too Foundation (1182179 AK; 1158085 FS-F-G)

University of Queensland (GB, FS-F-G, AK)

Walter and Eliza Hall Institute of Medical Research (CT, MD)

Betty Smyth Centenary Fellowship in Bioinformatics

UQ PhD scholarship

Australian and New Zealand Sarcoma Association Sarcoma

Grant Number

NHMRC Numbers : 2007919, 1157741, 1135898, 1140406, 1195451


Shojaei, M., Shamshirian, A., Monkman, J., Grice, L., Tran, M., Tan, C. W., ... & Tang, B. (2023). IFI27 transcription is an early predictor for COVID-19 outcomes, a multi-cohort observational study. Frontiers in Immunology, 13, Article 7847.



Robust biomarkers that predict disease outcomes amongst COVID-19 patients are necessary for both patient triage and resource prioritisation. Numerous candidate biomarkers have been proposed for COVID-19. However, at present, there is no consensus on the best diagnostic approach to predict outcomes in infected patients. Moreover, it is not clear whether such tools would apply to other potentially pandemic pathogens and therefore of use as stockpile for future pandemic preparedness.


We conducted a multi-cohort observational study to investigate the biology and the prognostic role of interferon alpha-inducible protein 27 (IFI27) in COVID-19 patients.


We show that IFI27 is expressed in the respiratory tract of COVID-19 patients and elevated IFI27 expression in the lower respiratory tract is associated with the presence of a high viral load. We further demonstrate that the systemic host response, as measured by blood IFI27 expression, is associated with COVID-19 infection. For clinical outcome prediction (e.g., respiratory failure), IFI27 expression displays a high sensitivity (0.95) and specificity (0.83), outperforming other known predictors of COVID-19 outcomes. Furthermore, IFI27 is upregulated in the blood of infected patients in response to other respiratory viruses. For example, in the pandemic H1N1/09 influenza virus infection, IFI27-like genes were highly upregulated in the blood samples of severely infected patients.


These data suggest that prognostic biomarkers targeting the family of IFI27 genes could potentially supplement conventional diagnostic tools in future virus pandemics, independent of whether such pandemics are caused by a coronavirus, an influenza virus or another as yet-to-be discovered respiratory virus.



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This work is licensed under a Creative Commons Attribution 4.0 License.

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