Saber Manal Mohamed, Nomair Azhar Mohamed, Osman Ashraf M, Nomeir Hanan Mohamed, Farag Naglaa M
Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia 61519, Egypt.
Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt.
Vaccines (Basel). 2022 Dec 19;10(12):2177. doi: 10.3390/vaccines10122177.
Data for predicting the severity and mortality of coronavirus disease 2019 (COVID-19) are limited, and investigations are ongoing. Endothelial monocyte-activating protein II (EMAP-II) is a multifunctional polypeptide with pro-inflammatory properties. EMAP-II is a significant pathogenic component in chronic inflammatory lung diseases and lung injury. In this study, we aimed to assess the potential utility of EMAP-II as a predictor of COVID-19 severity and mortality. This study included 20 healthy volunteers and 60 verified COVID-19 patients. Nasopharyngeal samples from COVID-19-positive subjects and normal volunteers were collected at admission. The nasopharyngeal samples were subjected to EMAP-II real-time polymerase chain reaction (RT-PCR). EMAP-II RNA was not detected in nasopharyngeal swabs of normal controls and mild to asymptomatic COVID-19 patients and was only detectable in severe COVID-19 patients. EMAP-II critical threshold (Ct) was positively associated with lymphocyte percentages and oxygen saturation (p < 0.001) while being negatively associated with age (p = 0.041), serum CRP, ferritin, and D-dimer levels (p < 0.001). EMAP-II Ct cutoff ≤34 predicted a worse outcome in COVID-19 illness, with a sensitivity and specificity of 100%. Our study suggests that EMAP-II could be considered a potential biomarker of COVID-19 severity. EMAP-II can predict the fatal outcome in COVID-19 patients.
预测2019冠状病毒病（COVID-19）严重程度和死亡率的数据有限，相关研究正在进行中。内皮单核细胞激活蛋白II（EMAP-II）是一种具有促炎特性的多功能多肽。EMAP-II是慢性炎症性肺病和肺损伤的重要致病成分。在本研究中，我们旨在评估EMAP-II作为COVID-19严重程度和死亡率预测指标的潜在效用。本研究纳入了20名健康志愿者和60名确诊的COVID-19患者。在入院时收集COVID-19阳性受试者和正常志愿者的鼻咽样本。对鼻咽样本进行EMAP-II实时聚合酶链反应（RT-PCR）检测。在正常对照和轻度至无症状COVID-19患者的鼻咽拭子中未检测到EMAP-II RNA，仅在重症COVID-19患者中可检测到。EMAP-II临界阈值（Ct）与淋巴细胞百分比和血氧饱和度呈正相关（p < 0.001），而与年龄（p = 0.041）、血清CRP、铁蛋白和D-二聚体水平呈负相关（p < 0.001）。EMAP-II Ct截止值≤34预测COVID-19病情预后较差，敏感性和特异性均为100%。我们的研究表明，EMAP-II可被视为COVID-19严重程度的潜在生物标志物。EMAP-II可以预测COVID-19患者的致命结局。
