Laboratory diagnostic value of neopterin measurements in patients with COVID-19 infection

Dietmar Fuchs,Magnus Gisslen

doi:10.1515/pteridines-2021-0001

Dietmar Fuchs, Magnus Gisslen

Open Access

https://doi.org/10.1515/pteridines-2021-0001

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Journal: Pteridines	Publication Date: Jan 1, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: Universität Innsbruck, University of Gothenburg

Abstract

Abstract The new coronavirus SARS-CoV-2 was identified to be responsible for the COVID-19 pandemic. There are striking differences in the response to infection, some people develop no or mild symptoms, while other outcomes are severe of even fatal. For those COVID-19 patients who require hospitalization, prognostic markers could help clinicians to identify patients with a poor outcome early. The serum levels of the immune activation marker neopterin have already been shown to be of prognostic value in patients with SARS-CoV-1 and a similar pattern can be observed for SARS-CoV-2. This comment discusses the biochemical circuits that support the clinical value of neopterin measurements in COVID-19 patients.

Highlights

At the end of 2019 the coronavirus SARS-CoV-2 was identified to be responsible for the new COVID-19 pandemic [1]
At the begin of November 2020, there have been more than 45 million confirmed cases of COVID-19, 1.2 million of deaths were reported to WHO [2]
The serum levels of the immune activation marker neopterin have shown to be of prognostic value in patients with SARS-CoV-1 [3] and first studies provide hints that serum neopterin could be helpful in stratifying SARS-CoV-2 patients [4,5,6]

Summary

Introduction

At the end of 2019 the coronavirus SARS-CoV-2 was identified to be responsible for the new COVID-19 pandemic [1]. The serum levels of the immune activation marker neopterin have shown to be of prognostic value in patients with SARS-CoV-1 [3] and first studies provide hints that serum neopterin could be helpful in stratifying SARS-CoV-2 patients [4,5,6]. Similar to HIV-1 infection, elevated neopterin concentrations in serum and CSF are common in patients with SARS-CoV-2 infection, and are predictive for the course of the infection [4,5,6]. The chemical effects of ROS were further enhanced in the presence of neopterin [8] Neopterin might represent another prooxidant in the mixture of redox-active compounds in the microenvironment of activated monocytic cells and play a role in the development of the so-called cytokine storm.

Tryptophan breakdown

Findings

Biochemistry related to increased neopterin production