Evaluation of the relationship between KIM-1 and suPAR levels and clinical severity in COVID-19 patients: A different perspective on suPAR.

Abstract

Coronavirus disease 2019 (COVID‐19) is one of the most pressing health problems of this century, but our knowledge of the disease is still limited. In this study, we aimed to examine serum‐soluble urokinase plasminogen activator receptor (suPAR) and kidney injury molecule 1 (KIM‐1) levels based on the clinical course of COVID‐19. Our study included 102 patients over the age of 18 who were diagnosed as having COVID‐19 between September 2020 and December 2020 and a control group of 50 health workers over the age of 18 whose severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) PCR results were negative. KIM‐1 was measured by ELISA and suPAR by suPARnostic™ assay. Analysis of previously identified variables of prognostic significance in COVID‐19 revealed high neutrophil to lymphocyte ratio, lactose dehydrogenase, prothrombin time, C‐reactive protein, PaO2/FiO2, D‐dimer, ferritin, and fibrinogen levels in patients with severe disease (p < 0.05 for all). KIM‐1 and suPAR levels were significantly higher in COVID‐19 patients compared to the control group (p = 0.001 for all). KIM‐1 level was higher in severe patients compared to moderate patients (p = 0.001), while suPAR level was lower (p = 0.001). KIM‐1, which is believed to play an important role in the endocytosis of SARS‐CoV‐2, was elevated in patients with severe COVID‐19 and may be a therapeutic target in the future. SuPAR may have a role in defense mechanism and fibrinolysis, and low levels in severe patients may be associated with poor prognosis in the early period.