重度新冠肺炎患者中低水平的α1抗胰蛋白酶和中性粒细胞与淋巴细胞比值升高与较高死亡率的相关性
Correlation of Low Levels of -1 Antitrypsin and Elevation of Neutrophil to Lymphocyte Ratio with Higher Mortality in Severe COVID-19 Patients.
作者信息
Shimi Ghazaleh, Sohrab Golbon, Pourvali Katayoun, Ghorbani Arman, Balam Farinaz Hosseini, Rostami Khalil, Zand Hamid
机构信息
Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Mediators Inflamm. 2021 Apr 28;2021:5555619. doi: 10.1155/2021/5555619. eCollection 2021.
BACKGROUND
Variations in COVID-19 prevalence, severity, and mortality rate remain ambiguous. Genetic or individual differences in immune response may be an explanation. Moreover, hyperinflammation and dysregulated immune response are involved in the etiology of severe forms of COVID-19. Therefore, the aim of the present study was to analyze serum alpha-1 antitrypsin (AAT) levels, as an acute-phase plasma protein with immunomodulatory effect and neutrophil to lymphocyte ratio (NLR) as a marker of inflammation response in severe COVID-19 illness.
METHODS
In this retrospective observational cohort study, 64 polymerase chain reaction (PCR) positive COVID-19 hospitalized patients were studied for AAT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), troponin, complete blood count (CBC), random blood sugar, serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), and arterial oxygen saturation (O2sat) at admission and during hospitalization.
RESULTS
The results showed that hospitalized patients with COVID-19 had low serum levels of AAT and high CRP levels at the first days of hospitalization. In particular, the percentages of individuals with low, normal, and high AAT levels were 7.80%, 82.80%, and 9.40%, respectively, while high and low values of CRP accounted for 86.70% and 13.30% of patients. Most of the patients had an upward neutrophil to lymphocyte ratio (NLR) trend, with a higher mortality rate ( < 0.05) and troponin levels ( < 0.05). However, comorbidities, CRP alterations, ESR alterations, nonfasting blood sugar, SGOT, SGPT, O2sat, RBC, and PLT values were not significantly different between the NLR downward and upward trend groups.
CONCLUSIONS
The current study revealed that severe COVID-19 patients had low serum AAT levels related to CRP values. Therefore, AAT response may be considered as a new mechanism by which some COVID-19 patients show immune dysregulation and more severe symptoms.
背景
新型冠状病毒肺炎（COVID-19）的患病率、严重程度和死亡率的变化仍不明确。免疫反应的基因或个体差异可能是一种解释。此外，过度炎症反应和免疫反应失调参与了重症COVID-19的病因。因此，本研究的目的是分析血清α-1抗胰蛋白酶（AAT）水平（一种具有免疫调节作用的急性期血浆蛋白）以及中性粒细胞与淋巴细胞比值（NLR），后者作为重症COVID-19疾病炎症反应的标志物。
方法
在这项回顾性观察队列研究中，对64例聚合酶链反应（PCR）阳性的COVID-19住院患者在入院时及住院期间进行了AAT、C反应蛋白（CRP）、红细胞沉降率（ESR）、肌钙蛋白、全血细胞计数（CBC）、随机血糖、血清谷氨酸草酰乙酸转氨酶（SGOT）、血清谷氨酸丙酮酸转氨酶（SGPT）和动脉血氧饱和度（O2sat）的检测。
结果
结果显示，COVID-19住院患者在住院初期血清AAT水平较低，CRP水平较高。具体而言，AAT水平低、正常和高的个体百分比分别为7.80%、82.80%和9.40%，而CRP高值和低值分别占患者的86.70%和13.30%。大多数患者的中性粒细胞与淋巴细胞比值（NLR）呈上升趋势，死亡率（<0.05）和肌钙蛋白水平（<0.05）较高。然而，NLR下降和上升趋势组之间的合并症、CRP变化、ESR变化、非空腹血糖、SGOT、SGPT、O2sat、红细胞（RBC）和血小板（PLT）值无显著差异。
结论
当前研究表明，重症COVID-19患者血清AAT水平较低，与CRP值相关。因此，AAT反应可被视为一些COVID-19患者出现免疫失调和更严重症状的一种新机制。
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