Decreased serum level of sphingosine-1-phosphate: a novel predictor of clinical severity in COVID-19.

Giovanni Marfia,Giuseppe Ciniglio Appiani,Rolando Campanella,Marco Locatelli,Fabrizio Palumbo,Stefano Centanni,Stefania Navone,Emanuele Garzia,Laura Guarnaccia,Monica Miozzo,Michele Mondoni,Laura Fontana,Laura Riboni,Alessandra Barassi,Davide Chiumello

doi:10.15252/emmm.202013424

Abstract

The severity of coronavirus disease 2019 (COVID‐19) is a crucial problem in patient treatment and outcome. The aim of this study is to evaluate circulating level of sphingosine‐1‐phosphate (S1P) along with severity markers, in COVID‐19 patients. One hundred eleven COVID‐19 patients and forty‐seven healthy subjects were included. The severity of COVID‐19 was found significantly associated with anemia, lymphocytopenia, and significant increase of neutrophil‐to‐lymphocyte ratio, ferritin, fibrinogen, aminotransferases, lactate dehydrogenase (LDH), C‐reactive protein (CRP), and D‐dimer. Serum S1P level was inversely associated with COVID‐19 severity, being significantly correlated with CRP, LDH, ferritin, and D‐dimer. The decrease in S1P was strongly associated with the number of erythrocytes, the major source of plasma S1P, and both apolipoprotein M and albumin, the major transporters of blood S1P. Not last, S1P was found to be a relevant predictor of admission to an intensive care unit, and patient’s outcome. Circulating S1P emerged as negative biomarker of severity/mortality of COVID‐19 patients. Restoring abnormal S1P levels to a normal range may have the potential to be a therapeutic target in patients with COVID‐19.

Highlights

The severity of coronavirus disease 2019 (COVID-19) is a crucial problem in patient treatment and outcome
We found multiple statistically significant differences between COV and HLT (Table EV3), including significant decrease in total proteins, albumin, total cholesterol, high-density lipoproteins (HDL)-C, 25-OH vitamin, and significant increase in fibrinogen, urea, ferritin, GGT, AST, ALT, C-reactive protein (CRP), lactate dehydrogenase (LDH), NT-proBNP, and IL-6
The major findings of this study are that serum S1P levels are significantly lower in COVID-19 patients than HLT and predict both intensive care unit (ICU) admission and in-hospital mortality

Summary

Introduction

The severity of coronavirus disease 2019 (COVID-19) is a crucial problem in patient treatment and outcome. The aim of this study is to evaluate circulating level of sphingosine-1-phosphate (S1P) along with severity markers, in COVID-19 patients. One hundred eleven COVID-19 patients and forty-seven healthy subjects were included. The severity of COVID-19 was found significantly associated with anemia, lymphocytopenia, and significant increase of neutrophil-tolymphocyte ratio, ferritin, fibrinogen, aminotransferases, lactate dehydrogenase (LDH), C-reactive protein (CRP), and D-dimer. Serum S1P level was inversely associated with COVID-19 severity, being significantly correlated with CRP, LDH, ferritin, and D-dimer. Circulating S1P emerged as negative biomarker of severity/mortality of COVID-19 patients. Restoring abnormal S1P levels to a normal range may have the potential to be a therapeutic target in patients with COVID-19

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Conclusion