Department of Biochemical Diagnostics, Medical University of Bialystok, Waszyngtona 15A, 15-269, Bialystok, Poland.
Department of Gastroenterology, Hepatology and Internal Diseases, Voivodeship Hospital in Bialystok, Bialystok, Poland.
Sci Rep. 2024 Sep 2;14(1):20360. doi: 10.1038/s41598-024-71325-2.
The aim of the study was to conduct of relationship of acute-phase proteins (APPs) with the severity of COVID-19 defined by National Institutes of Health and according to the criteria of MEWS scale, with the presence of a cytokine storm, oxygen therapy and patient survival. We enrolled 96 patients with COVID-19 and 30 healthy people. The samples were taken on the day of admission and after 9 days on average. Not only commonly used APPs such as CRP, procalcitonin and ferritin and also rarely assayed proteins such as transferrin, haptoglobin, α1-acid glycoprotein and α1-antitrypsin, were tested in the study. The levels of APPs depends on the severity of COVID-19 disease, on the presence of cytokine storm and used oxygen therapy. The greatest APPs changes occurred in the most advanced form of the disease, with the presence of a cytokine storm and the most intense oxygen therapy. The results obtained from MEWS scale were not consistent with National Institutes of Health scores. Studies in the second samples showed the quenching of the acute phase reactions and the effectiveness of oxygen therapy. Only two of the examined APPs i.e. procalcitonin and transferrin, differed between surviving and non-surviving patients, and these two predispose to the role of prognostic factors in Covid-19. In conclusion, the concentration of not all acute-phase proteins depends on the severity of COVID-19 disease, presence of cytokine storm, the used of oxygen therapy and only some of them (procalcitonin and transferrin) are related to the survival outcomes. Of the newly tested acute-phase proteins, only transferrin shows significance as a marker of disease severity and mortality in COVID-19 disease.
本研究的目的是探讨急性时相蛋白（APPs）与美国国立卫生研究院（NIH）定义的 COVID-19 严重程度之间的关系，并根据 MEWS 量表的标准，与细胞因子风暴、氧疗和患者生存情况进行比较。我们纳入了 96 例 COVID-19 患者和 30 例健康人。标本分别于入院当天和平均 9 天后采集。研究中不仅检测了常用的 APPs（如 CRP、降钙素原和铁蛋白），还检测了很少检测的蛋白质（如转铁蛋白、触珠蛋白、α1-酸性糖蛋白和α1-抗胰蛋白酶）。APPs 的水平取决于 COVID-19 疾病的严重程度、细胞因子风暴的存在和使用的氧疗。在疾病的最严重形式、存在细胞因子风暴和最强烈的氧疗时，APPs 的变化最大。MEWS 评分的结果与 NIH 评分不一致。第二份样本的研究表明，急性时相反应受到抑制，氧疗有效。在存活和非存活患者之间仅两种检查的 APPs（降钙素原和转铁蛋白）有所不同，这两种 APPs 可能成为 COVID-19 预后因素。总之，并非所有急性时相蛋白的浓度都取决于 COVID-19 疾病的严重程度、细胞因子风暴的存在、氧疗的应用，只有其中一些（降钙素原和转铁蛋白）与生存结果相关。在新检测的急性时相蛋白中，只有转铁蛋白作为 COVID-19 疾病严重程度和死亡率的标志物具有显著意义。
