期刊
CLINICA CHIMICA ACTA
卷 537, 期 -, 页码 140-145出版社
ELSEVIER
DOI: 10.1016/j.cca.2022.10.013
关键词
COVID-19; Mortality; SARS-CoV-2 infection; Surfactant protein-D (SP-D)
资金
- Fondazione Cariplo
- Fondazione Banco Farmaceutico, Italy
SP-D can serve as a predictive biomarker for COVID-19 disease and its outcome. Elevated plasma levels of SP-D are associated with disease severity and mortality. Monitoring SP-D levels in hospitalized patients can guide therapeutic interventions.
Background: Surfactant protein-D (SP-D) is a lung-resident protein that has emerged as a potential biomarker for COVID-19. Previous investigations on acute respiratory distress syndrome patients demonstrated a significant increment of SP-D serum levels in pathological conditions. Since SP-D is not physiologically permeable to alveolicapillary membrane and poorly expressed by other tissues, this enhancement is likely due to an impairment of the pulmonary barrier caused by prolonged inflammation. Methods: A retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio was conducted to assess differences of the hematic SP-D concentrations among COVID-19 patients and healthy donors and if SPD levels resulted a risk factor for disease severity and mortality. Results: The first analysis, using an ANOVA-model, showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors. Significant variations were also found between dead vs survived patients. Results confirm that SP-D concentrations were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. Further analysis conducted with Logistic Mixed models, highlighted that higher SP-D levels at admission and increasing differences among follow-up and admission values resulted the strongest significant risk factors of mortality (model predictive accuracy, AUC = 0.844). Conclusions: The results indicate that SP-D can be a predictive marker of COVID-19 disease and its outcome. Considering its prognostic value in terms of mortality, the early detection of SP-D levels and its follow-up in hospitalized patients should be considered to direct the therapeutic intervention.
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