Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Tlalpan, Mexico City, Mexico.
PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Sci Rep. 2022 Feb 3;12(1):1856. doi: 10.1038/s41598-022-05968-4.
Severe COVID-19 is associated with a systemic hyperinflammatory response leading to acute respiratory distress syndrome (ARDS), multi-organ failure, and death. Galectin-3 is a ß-galactoside binding lectin known to drive neutrophil infiltration and the release of pro-inflammatory cytokines contributing to airway inflammation. Thus, we aimed to investigate the potential of galectin-3 as a biomarker of severe COVID-19 outcomes. We prospectively included 156 patients with RT-PCR confirmed COVID-19. A severe outcome was defined as the requirement of invasive mechanical ventilation (IMV) and/or in-hospital death. A non-severe outcome was defined as discharge without IMV requirement. We used receiver operating characteristic (ROC) and multivariable logistic regression analysis to determine the prognostic ability of serum galectin-3 for a severe outcome. Galectin-3 levels discriminated well between severe and non-severe outcomes and correlated with markers of COVID-19 severity, (CRP, NLR, D-dimer, and neutrophil count). Using a forward-stepwise logistic regression analysis we identified galectin-3 [odds ratio (OR) 3.68 (95% CI 1.47-9.20), p < 0.01] to be an independent predictor of severe outcome. Furthermore, galectin-3 in combination with CRP, albumin and CT pulmonary affection > 50%, had significantly improved ability to predict severe outcomes [AUC 0.85 (95% CI 0.79-0.91, p < 0.0001)]. Based on the evidence presented here, we recommend clinicians measure galectin-3 levels upon admission to facilitate allocation of appropriate resources in a timely manner to COVID-19 patients at highest risk of severe outcome.
严重的 COVID-19 与全身性过度炎症反应有关，导致急性呼吸窘迫综合征（ARDS）、多器官衰竭和死亡。半乳糖凝集素-3 是一种已知能驱动中性粒细胞浸润和释放促炎细胞因子的β-半乳糖苷结合凝集素，导致气道炎症。因此，我们旨在研究半乳糖凝集素-3 作为严重 COVID-19 结局的生物标志物的潜力。我们前瞻性纳入了 156 例经 RT-PCR 确诊的 COVID-19 患者。严重结局定义为需要有创机械通气（IMV）和/或院内死亡。非严重结局定义为无需 IMV 即可出院。我们使用受试者工作特征（ROC）和多变量逻辑回归分析来确定血清半乳糖凝集素-3 对严重结局的预后能力。半乳糖凝集素-3 水平能很好地区分严重和非严重结局，并与 COVID-19 严重程度的标志物（CRP、NLR、D-二聚体和中性粒细胞计数）相关。通过向前逐步逻辑回归分析，我们确定半乳糖凝集素-3 [比值比（OR）3.68（95%CI 1.47-9.20），p<0.01]是严重结局的独立预测因子。此外，半乳糖凝集素-3 与 CRP、白蛋白和 CT 肺部受累>50%联合使用，显著提高了预测严重结局的能力 [AUC 0.85（95%CI 0.79-0.91，p<0.0001)]。根据这里提出的证据，我们建议临床医生在入院时测量半乳糖凝集素-3 水平，以便及时为处于严重结局风险最高的 COVID-19 患者分配适当的资源。
