Abstract
Severe coronavirus disease 2019 (COVID-19) is associated with hyperinflammation leading to organ injury, including respiratory failure. Galectin-3 was implicated in innate immunological response to infections and in chronic fibrosis. The aim of our preliminary study was the assessment of the diagnostic utility of serum galectin-3 in patients with COVID-19. The prospective observational study included adult patients admitted with active COVID-19 and treated in tertiary hospital between June and July 2020. The diagnosis was confirmed by the quantitative detection of nucleic acid of severe acute respiratory syndrome coronavirus 2 in nasopharyngeal swabs. Galectin-3 was measured by enzyme immunoassay in serum samples obtained during the first five days of hospital stay. We included 70 patients aged 25 to 73 years; 90% had at least one comorbidity. During the hospital stay, 32.9% were diagnosed with COVID-19 pneumonia and 12.9% required treatment in the intensive care unit (ICU). Serum galectin-3 was significantly increased in patients who developed pneumonia, particularly those who required ICU admission. Positive correlations were found between galectin-3 and inflammatory markers (interleukin-6, C-reactive protein, ferritin, pentraxin-3), a marker of endothelial injury (soluble fms-like tyrosine kinase-1), and a range of tissue injury markers. Serum galectin-3 enabled the diagnosis of pneumonia with moderate diagnostic accuracy and the need for ICU treatment with high diagnostic accuracy. Our findings strengthen the hypothesis that galectin-3 may be involved in severe COVID-19. Further studies are planned to confirm the preliminary results and to verify possible associations of galectin-3 with long-term consequences of COVID-19, including pulmonary fibrosis.
Highlights
A spectrum of complications observed in patients with coronavirus disease 2019(COVID-19) is not restricted to the widely recognized severe acute respiratory syndrome.The complications may include exacerbation of comorbidities, coagulopathies, bacterial superinfections with increased risk of sepsis, and multiple organ failure (MOF) [1]
Angiopoietin-2, a marker of endothelial activation and injury observed in acute inflammatory states, has been associated with the need for intensive care unit (ICU) admission in COVID-19 [12]. We included another laboratory marker associated with endothelial dysfunction, the soluble fms-type tyrosine kinase 1, which we have previously shown to correlate with serum angiopoietin-2 and to predict organ failure and coagulopathy in acute pancreatitis [13,14]
The aim of our preliminary study was the assessment of the diagnostic utility of serum galectin-3 concentrations in patients with COVID-19 of various severity, in comparison to other relevant markers, including a wide panel of recommended laboratory tests, and serum concentrations of PTX-3 and Soluble fms-like tyrosine kinase-1 (sFlt-1)
Summary
(COVID-19) is not restricted to the widely recognized severe acute respiratory syndrome. Considering the dynamic changes in clinical state of patients with severe COVID-19, there is a need to optimize the list of laboratory tests balancing the time-relevant and potentially time-limited parameters. The high incidence of thromboembolic events in COVID-19 patients point to the endothelial injury developing in the course of the disease This may be caused by both the cytokine storm and the direct action of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entering endothelial cells through the binding of viral spike protein with the cell membrane angiotensin-converting enzyme 2 (ACE-2) [8,9]. The aim of our preliminary study was the assessment of the diagnostic utility of serum galectin-3 concentrations in patients with COVID-19 of various severity, in comparison to other relevant markers, including a wide panel of recommended laboratory tests, and serum concentrations of PTX-3 and sFlt-1
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