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[评估血清五聚体-3和可溶性尿激酶型纤溶酶原激活物受体水平作为新型冠状病毒肺炎患者急性期反应物的情况]

[Evaluation of Serum Pentraxin-3 and suPAR Levels as Acute Phase Reactants in Patients with COVID-19].

作者信息

Akbayırlı Ufuk, Kaya Selçuk, Aksoy Gökmen Ayşegül

机构信息

İzmir Katip Çelebi University Faculty of Medicine, Department of Medical Microbiology, İzmir, Türkiye.

出版信息

Mikrobiyol Bul. 2022 Oct;56(4):631-644. doi: 10.5578/mb.20229603.

Abstract

Coronavirus disease-2019 (COVID-19) is the most challenging health problem of our century, but our knowledge about the disease is limited. Most individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes COVID-19, have mild symptoms such as headache, sore throat, joint pain, loss of sense of taste and smell. However, infection also causes significant morbidity and mortality, especially in individuals over 65 years of age with comorbidities. However, it is not known exactly which patients will have a poor prognosis. In this study, it was aimed to determine serum Pentraxin-3 (PTX3) and soluble urokinase plasminogen activator receptor (suPAR) levels in COVID-19 patients, and to evaluate the relationship between PTX3 and suPAR levels and the clinical status of the disease. This study was conducted with 150 patients who were confirmed to have COVID-19 by microbiological or clinical/radiological methods between April 1 and December 31, 2020. Thirty people with no known history or symptoms of COVID-19 and negative reverse transcription-polymerase chain reaction (RT-PCR) results also constituted the control group. Patients admitted to inpatient services due to COVID-19 constituted the service group (n= 75) and patients admitted to the intensive care unit (ICU) constituted the ICU group (n= 75). Serum PTX3 and suPAR levels were analyzed by enzyme-linked immunoassay (ELISA) and the results were compared between the three groups. The patients' leukocyte, neutrophil, neutrophil/lymphocyte ratio (NLR), troponin, procalcitonin (PCT), D-dimer, C-reactive protein (CRP), lymphocyte and ferritin results were included in the analysis. The mean age of the patients was 67.2 ± 11.8, and 62.0 ± 8.4 in the control group. There was no significant difference between the groups in terms of female/male ratio (p= 0.582). The PTX3 and suPAR levels of the patients were higher than the controls (p= 0.001, p= 0.023, respectively). PTX3 and suPAR levels were higher in the service group than the ICU group (p<0.001, p= 0.004, respectively) and the control group (p<0.001, p= 0.001, respectively). However, PTX3 (p= 0.291) and suPAR (p= 0.411) concentrations did not differ between ICU and control groups. The most determining parameters in ICU admission were found to be leukocytes (AUC= 0.840), neutrophils (AUC= 0.840), and NLR (AUC= 0.835), respectively. The most predictive parameters for mortality were PCT (AUC= 0.712), NLR (AUC= 0.708) and D-dimer (AUC= 0.695), respectively. In our study, serum PTX3 and suPAR concentrations were found to be high in COVID-19 patients. In patients admitted to the ICU, PTX3 and suPAR levels were observed at low levels. Low levels of PTX3 and suPAR in COVID-19 patients were thought to be clinically important.

摘要

2019冠状病毒病(COVID-19)是我们这个世纪最具挑战性的健康问题,但我们对该疾病的了解有限。大多数感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即导致COVID-19的病毒)的个体有轻微症状,如头痛、喉咙痛、关节疼痛、味觉和嗅觉丧失。然而,感染也会导致显著的发病率和死亡率,尤其是在65岁以上患有合并症的个体中。然而,目前尚不清楚哪些患者预后较差。在本研究中,旨在测定COVID-19患者血清中五聚体3(PTX3)和可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平,并评估PTX3和suPAR水平与疾病临床状况之间的关系。本研究纳入了150例在2020年4月1日至12月31日期间通过微生物学或临床/放射学方法确诊为COVID-19的患者。30例无COVID-19病史或症状且逆转录聚合酶链反应(RT-PCR)结果为阴性的患者也构成了对照组。因COVID-19入住住院病房的患者构成病房组(n = 75),入住重症监护病房(ICU)的患者构成ICU组(n = 75)。采用酶联免疫吸附测定(ELISA)分析血清PTX3和suPAR水平,并比较三组结果。患者的白细胞、中性粒细胞、中性粒细胞/淋巴细胞比值(NLR)、肌钙蛋白、降钙素原(PCT)、D-二聚体、C反应蛋白(CRP)、淋巴细胞和铁蛋白结果纳入分析。患者的平均年龄为67.2±11.8岁,对照组为62.0±8.4岁。各组间男女比例无显著差异(p = 0.582)。患者的PTX3和suPAR水平高于对照组(分别为p = 0.001,p = 0.023)。PTX3和suPAR水平在病房组高于ICU组(分别为p<0.001,p = 0.004)和对照组(分别为p<0.001,p = 0.001)。然而,ICU组和对照组之间的PTX3(p = 0.291)和suPAR(p = 0.411)浓度无差异。发现入住ICU的最具决定性参数分别为白细胞(AUC = 0.840)、中性粒细胞(AUC = 0.840)和NLR(AUC = 0.835)。死亡的最具预测性参数分别为PCT(AUC = 0.712)、NLR(AUC = 0.708)和D-二聚体(AUC = 0.695)。在我们的研究中,发现COVID-19患者血清PTX3和suPAR浓度较高。在入住ICU的患者中,PTX3和suPAR水平较低。COVID-19患者中PTX3和suPAR水平较低被认为具有临床重要性。

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