Evaluation of Serum Pentraxin-3 and suPAR Levels as Acute Phase Reactants in Patients with COVID-19

Abstract

Coronavirus disease-2019 (COVID-19) is the most challenging health problem of our century, but our knowledge about the disease is limited. Most individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes COVID-19, have mild symptoms such as headache, sore throat, joint pain, loss of sense of taste and smell. However, infection also causes significant morbidity and mortality, especially in individuals over 65 years of age with comorbidities. However, it is not known exactly which patients will have a poor prognosis. In this study, it was aimed to determine serum Pentraxin-3 (PTX3) and soluble urokinase plasminogen activator receptor (suPAR) levels in COVID-19 patients, and to evaluate the relationship between PTX3 and suPAR levels and the clinical status of the disease. This study was conducted with 150 patients who were confirmed to have COVID-19 by microbiological or clinical/radiological methods between April 1 and December 31, 2020. Thirty people with no known history or symptoms of COVID-19 and negative reverse transcription-polymerase chain reaction (RT-PCR) results also constituted the control group. Patients admitted to inpatient services due to COVID-19 constituted the service group (n= 75) and patients admitted to the intensive care unit (ICU) constituted the ICU group (n= 75). Serum PTX3 and suPAR levels were analyzed by enzyme-linked immunoassay (ELISA) and the results were compared between the three groups. The patients' leukocyte, neutrophil, neutrophil/lymphocyte ratio (NLR), troponin, procalcitonin (PCT), D-dimer, C-reactive protein (CRP), lymphocyte and ferritin results were included in the analysis. The mean age of the patients was 67.2 ± 11.8, and 62.0 ± 8.4 in the control group. There was no significant difference between the groups in terms of female/male ratio (p= 0.582). The PTX3 and suPAR levels of the patients were higher than the controls (p= 0.001, p= 0.023, respectively). PTX3 and suPAR levels were higher in the service group than the ICU group (p<0.001, p= 0.004, respectively) and the control group (p<0.001, p= 0.001, respectively). However, PTX3 (p= 0.291) and suPAR (p= 0.411) concentrations did not differ between ICU and control groups. The most determining parameters in ICU admission were found to be leukocytes (AUC= 0.840), neutrophils (AUC= 0.840), and NLR (AUC= 0.835), respectively. The most predictive parameters for mortality were PCT (AUC= 0.712), NLR (AUC= 0.708) and D-dimer (AUC= 0.695), respectively. In our study, serum PTX3 and suPAR concentrations were found to be high in COVID-19 patients. In patients admitted to the ICU, PTX3 and suPAR levels were observed at low levels. Low levels of PTX3 and suPAR in COVID-19 patients were thought to be clinically important.