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New Insights in Laboratory Testing for COVID-19 Patients: Looking for the Role and Predictive Value of Human epididymis secretory protein 4 (HE4) and the Innate Immunity of the Oral Cavity and Respiratory Tract.
Schirinzi, Annalisa; Cazzolla, Angela Pia; Lovero, Roberto; Lo Muzio, Lorenzo; Testa, Nunzio Francesco; Ciavarella, Domenico; Palmieri, Giuseppe; Pozzessere, Pietro; Procacci, Vito; Di Serio, Francesca; Santacroce, Luigi.
  • Schirinzi A; AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Clinical Pathology Unit, 70124 Bari, Italy.
  • Cazzolla AP; Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy.
  • Lovero R; AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Clinical Pathology Unit, 70124 Bari, Italy.
  • Lo Muzio L; Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy.
  • Testa NF; Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy.
  • Ciavarella D; Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy.
  • Palmieri G; Private Practice, 70124 Bari, Italy.
  • Pozzessere P; AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Emergency Medicine and Surgery Unit, 70124 Bari, Italy.
  • Procacci V; AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Emergency Medicine and Surgery Unit, 70124 Bari, Italy.
  • Di Serio F; AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Clinical Pathology Unit, 70124 Bari, Italy.
  • Santacroce L; Ionian Department (DJSGEM), Microbiology and Virology Lab, Università Degli Studi di Bari, 70124 Bari, Italy.
Microorganisms ; 8(11)2020 Nov 02.
Article in English | MEDLINE | ID: covidwho-971452
ABSTRACT
COVID-19 is a viral pandemic caused by the new coronavirus SARS-CoV-2, an enveloped positive stranded RNA virus. The mechanisms of innate immunity, considered as the first line of antiviral defense, is essential towards viruses. A significant role in host defense of the lung, nasal and oral cavities is played by Human epididymis secretory protein 4 (HE4) HE4 has been demonstrated to be serum inflammatory biomarker and to show a role in natural immunity at the level of oral cavity, nasopharynx and respiratory tract with both antimicrobial/antiviral and anti-inflammatory activity. Several biomarkers like IL-6, presepsin (PSP), procalcitonin (PCT), CRP, D-Dimer have showed a good function as predictor factors for the clinical evolution of COVID-19 patients (mild, severe and critical). The aim of this study was to correlate the blood levels of CRP, IL-6, PSP, PCT, D-Dimer with He4, to identify the predictive values of these biomarkers for the evolution of the disease and to evaluate the possible role of HE4 in the defense mechanisms of innate immunity at the level of oral cavity, nasopharynx and respiratory tract. Of 134 patients admitted at COVID hospital of Policlinico-University of Bari, 86 (58 men age 67.6 ± 12.4 and 28 women age 65.7 ± 15.4) fulfilled the inclusion criteria in particular, 80 patients (93%) showed prodromal symptoms (smell and/or taste dysfunctions) and other typical clinical manifestations and 19 died (13 men age 73.4 ± 7.7 and 6 women age 74.8 ± 6.7). 48 patients were excluded because 13 finished chemotherapy and 6 radiotherapy recently, 5 presented suspected breast carcinoma, 5 suspected lung carcinoma, 6 suspected ovarian carcinoma or ovary cyst, 1 cystic fibrosis, 3 renal fibrosis and 9 were affected by autoimmune diseases in treatment with monoclonal antibodies. The venous sample was taken for each patient on the admission and during the hospital stay. For each patient, six measurements relating to considered parameters were performed. Significant correlations between He4 and IL-6 levels (r = 0.797), between He4 and PSP (r = 0.621), between He4 and PCT (r = 0.447), between He4 and D-Dimer (r = 0.367), between He4 and RCP (r = 0.327) have been found. ROC curves analysis showed an excellent accuracy for He4 (AUC = 0.92) and IL-6 (AUC = 0.91), a very good accuracy for PSP (AUC = 0.81), a good accuracy for PCT (AUC = 0.701) and D-Dimer (AUC = 0.721) and sufficient accuracy for RCP (AUC = 0.616). These results demonstrated the important correlation between He4, IL6 and PSP, an excellent accuracy of He4 and IL6 and showed a probable role of He4 in the innate immunity in particularly at the level of oral cavity, nasopharynx and respiratory tract. Besides He4 together with IL6 might be involved in the onset of smell and/or taste disorders and it might be used as innovative biomarker to monitor clinical evolution of COVID-19 because He4 could indicate a multi-organ involvement.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Year: 2020 Document Type: Article Affiliation country: Microorganisms8111718

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Language: English Year: 2020 Document Type: Article Affiliation country: Microorganisms8111718