Evaluation of the relationship between TAFI level and prognosis in COVID-19 patients.

OBJECTIVE: Serum thrombin-activated fibrinolysis inhibitor (TAFI) levels were measured in coronavirus disease 2019 (COVID-19) patients requiring intensive care, clinical hospitalization, and outpatient follow-up. The relationships between serum TAFI levels and prognosis were determined. PATIENTS AND METHODS: Ninety patients who had positive COVID-19 PCR test results were randomly selected and included in the study. Subgroups were formed according to the clinical characteristics of the patients as follows: mild, moderate, and severe. Venous blood samples were taken from all patients, and serum C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, D-dimer, ferritin, and TAFI levels were measured. The results were evaluated by comparing each group. RESULTS: The one-way ANOVA test to determine differences between subgroups resulted in p-values lower than 0.05 for all biochemical analytes (CRP, LDH, fibrinogen, D-dimer, ferritin, and TAFI). Regarding serum TAFI levels, there were significant differences in the severe group (853.04 ± 338.58 ng/mL) compared to the mild group (548.33 ± 264.17 ng/mL). ROC curve analysis to predict mortality revealed that TAFI levels were able to detect 85% of deaths. In addition, ROC analysis revealed that serum TAFI levels could detect 86% of intubated cases. CONCLUSIONS: The disease progression is more severe in patients with high TAFI levels, and high TAFI levels are associated with mortality and intubation rates. Further studies are needed to determine serum TAFI levels as a biomarker of prognosis in COVID-19 patients.

Could Metrnl be a New Biomarker to Predict the Development of Macrophage Activation Syndrome in COVID-19 Patients?

Introduction: Failure to maintain the inflammatory and anti-inflammatory balance during COVID-19 treatment may result in a severe clinical course. In our study, we aimed to determine the relationship between the meteorin-like protein (metrnl), which plays a role in the anti-inflammatory balance, and the clinical course. Material(s) and Method(s): Between October 2021 and December 2021, 160 patients who were hospitalized in our hospital and whose delta variant COVID-19 infection was confirmed and 80 healthy controls, were enrolled in the study. Patients were divided into two groups according to the severity degree of COVID-19 (Group 1: Moderate COVID-19, Group 2: Severe COVID-19 MAS). Result(s): When comparing the metrnl levels of the groups, it was observed that the metrnl level was statistically significantly lower in Group 2 patients (p< 0.001). While no statistically significant difference was observed between the healthy control group and Group 1, it was observed that the metrnl level of Group 2 patients was statistically significantly lower than the healthy control group (p= 0.77, <0.001 respectively). In the ROC curve analysis of Metrnl level performed in Group 1 and 2 patients, the cut-off value was taken as 17.54 ng/mL, its sensitivity was observed as 80% and the specificity was observed as 60% in predicting the development of severe COVID-19 in patients whose levels were below this value. Conclusion(s): The low level of metrnl, which is thought to play a key role in anti-inflammatory balance, contributes to the development of macrophage activation syndrome, which leads to the severe clinical course in COVID-19 patients.Copyright © 2023 Bilimsel Tip Yayinevi. All rights reserved.

The relationship between COVID-19 and the complement system: mannose-binding lectin.

OBJECTIVE: Mannose-binding lectin (MBL) is one of the important parts of the complement system. In our study, we aimed to determine serum MBL levels and their relationship with intensive care hospitalization. PATIENTS AND METHODS: Ninety COVID-19-positive patients from outpatient clinics and clinics were included in this study. The patients were evaluated in three groups as mild, moderate, and severe groups. Each group consisted of 30 patients. A venous blood sample was taken once from each patient. Serum MBL, C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, D-dimer, and ferritin levels were measured. RESULTS: The mean serum MBL levels of all patients were 695.46±324.42 ng/mL. One-way ANOVA test resulted in significant differences in serum CRP, LDH, fibrinogen, D-dimer, ferritin, and MBL levels between groups (p<0.05 for all comparisons). Post-hoc Tukey analysis showed significant differences in serum MBL levels between mild and severe groups and moderate and severe groups. CONCLUSIONS: MBL may be used as a prognostic biomarker in COVID-19 patients. Further studies are needed to determine MBL in treatment strategies.