Journal Article

Acute Lung Injury Biomarkers in the Prediction of COVID-19 Severity: Total Thiol, Ferritin and Lactate Dehydrogenase

Martinez Mesa, Alvaro, Martín-Montañez, Elisa, Velasco Garrido, Jose Luis, Cabrera César, Eva, Romero-Zerbo, Yanina, Sanchez Alvarez, Esther, Lopez, Pilar Martinez, Garcia-Fernandez, Maria

2021

Overview

SARS-CoV-2 (COVID-19) patients who develop acute respiratory distress syndrome (ARDS) can suffer acute lung injury, or even death. Early identification of severe disease is essential in order to control COVID-19 and improve prognosis. Oxidative stress (OS) appears to play an important role in COVID-19 pathogenesis; we therefore conceived a study of the potential discriminative ability of serum biomarkers in patients with ARDS and those with mild to moderate disease (non-ARDS). 60 subjects were enrolled in a single-centre, prospective cohort study of consecutively admitted patients: 29 ARDS/31 non-ARDS. Blood samples were drawn and marker levels analysed by spectrophotometry and immunoassay techniques. C-reactive protein (CRP), lactate dehydrogenase (LDH), and ferritin were significantly higher in ARDS versus non-ARDS cases at hospital admission. Leukocytes, LDH, ferritin, interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) were also significantly elevated in ARDS compared to non-ARDS patients during the hospital stay. Total thiol (TT) was found to be significantly lower in ARDS. Conversely, D-dimer, matrix metalloproteinase-9 (MMP-9) and advanced glycosylated end products (AGE) were elevated. Leukocytes, LDH, CRP, ferritin and IL-6 were found to be significantly higher in non-survivors. However, lymphocyte, tumour necrosis factor beta (TGF-β), and TT were lower. In summary, our results support the potential value of TT, ferritin and LDH as prognostic biomarkers for ARDS development in COVID-19 patients, distinguishing non-ARDS from ARDS (AUCs = 0.92; 0.91; 0.89) in a fast and cost-effective manner. These oxidative/inflammatory parameters appear to play an important role in COVID-19 monitoring and can be used in the clinical management of patients.

• Publisher: MDPI AG,MDPI
• Subject: acute respiratory distress syndrome / Age / Biomarkers / blood serum / C-reactive protein / cohort studies / Coronaviruses / cost effectiveness / COVID-19 / COVID-19 infection / death / Dehydrogenases / Disease / disease severity / Epidemics / Ferritin / Gelatinase B / glycosylation / hospitals / Illnesses / immunoassays / Inflammation / Interleukin 6 / L-Lactate dehydrogenase / Laboratories / lactate dehydrogenase / Lactic acid / LDH / Leukocytes / Lungs / Lymphocytes / Matrix metalloproteinase / Metalloproteinase / Oxidative stress / Pathogenesis / Patients / Pneumonia / prediction / prognosis / Respiratory diseases / Respiratory distress syndrome / Severe acute respiratory syndrome coronavirus 2 / Spectrophotometry / spectroscopy / Statistical analysis / thiols / total thiol / tumor necrosis factor-alpha / Tumor necrosis factor-α / Tumors / Ventilators