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Κυριακή 15 Ιανουαρίου 2023

Efficacy of Serum Apelin and Galectin‐3 as Potential Predictors of Mortality in Severe COVID‐19 Patients

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Abstract

Background

Apelin is a cardioprotective biomarker while galectin-3 is a proinflammatory and profibrotic biomarker. Endothelial dysfunction, hyperinflammation, and pulmonary fibrosis are key mechanisms that contribute to the development of adverse outcomes in COVID-19 infection. This study aims to analyze the prognostic value of serum apelin and galectin-3 levels to early predict patients at high risk of mortality in patients hospitalized for severe COVID-19 pneumonia.

Methods

The study included 78 severe COVID-19 patients and 40 healthy controls. The COVID-19 patients were divided into 2 groups, survivors and non-survivors, according to their in-hospital mortality status. Basic demographic and clinical data of all patients were collected and blood samples were taken before treatment.

Results

In our study, serum apelin levels were determined to be significantly lower in both non-survivor and survivor COVID-19 patients compared to the control subjects (for both groups, p<0.001). However, serum apelin levels were similar in survivor and non-survivor COVID-19 patients (p>0.05). Serum galectin-3 levels were determined to be higher in a statistically significant way in non-survivors compared to survivors and controls (for both groups; p<0.001). Additionally, serum galectin-3 levels were significantly higher in the survivor patients compared to the control subjects (p<0.001). Positive correlations were observed between galectin-3 and age, ferritin, CK-MB and NT-proBNP variables (r=0.32, p=0.004; r=0.24, p=0.04; r=0.24, p=0.03 and r=0.33, p=0.003, respectively) while a negative correlation was observed between galectin-3 and albumin (r=-0.31, p=0.006). Multiple logistic regression analysis revealed that galectin-3 was an independent predictor of mortality in COVID -19 patients (OR=2.272, 95% CI, 1.106-4.667; p=0.025). When the threshold value for galectin-3 was regarded as 2.8 ng/mL, it was discovered to predict mortality with 80% sensitivity and 57% specificity (AUC: 0.738, 95% CI: 0.611-0.866, p=0.002).

Conclusion

Galectin-3 might be a simple, useful, and prognostic biomarker that can be utilized to predict patients who are at high risk of mortality in severe COVID-19 patients.

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