Evaluation of circulating insulin-like growth factor-1, heart-type fatty acid-binding protein, and endotrophin levels as prognostic markers of COVID-19 infection severity

Coronavirus Disease 2019 (COVID-19) is a worldwide pandemic challenge spreading enormously within a few months. COVID-19 is characterized by the over-activation of the immune system causing cytokine storm. Insulin-like growth factor-1 (IGF-1) pathway can regulate the immune response via interaction...

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Published in:	Virology journal Vol. 20; no. 1; p. 94
Main Authors:	Mohamed, Amal A, Nour, Aya A, Mosbah, Noha M, Wahba, Alaa S M, Esmail, Omnia E, Eysa, Basem, Heiba, Ahmed, Samir, Hussin H, El-Kassas, Ahmed A, Adroase, Ahmed S, Elamir, Ahmed Y, Mahmoud, Ghada M, Rafaat, Rasha S, Hassan, Hatem A, El Abd, Yasmine S
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 15-05-2023 BioMed Central BMC
Subjects:	Biological markers Biomarkers Body mass index Carrier proteins Collagen Coronaviruses COVID-19 COVID-19 - diagnosis Cytokine storm Cytokines Cytokines - metabolism Development and progression Egypt Epidemics ETP Fatty Acid Binding Protein 3 Fatty acid-binding protein Fatty Acid-Binding Proteins Fatty acids Ferritin Fibrosis Health aspects HFABP Humans Hypoxemia IGF-1 Immune response Infection Inflammation Insulin Insulin-like growth factor 1 Insulin-like growth factor I Insulin-Like Growth Factor I - metabolism Insulin-like growth factors Liver Lung diseases Lymphopenia Measurement Medical research Medicine, Experimental Morbidity Mortality Procalcitonin Prognosis Protein binding SARS-CoV-2 Virus diseases Egypt China COVID-19 ETP SARS-CoV-2 IGF-1 HFABP
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Summary:	Coronavirus Disease 2019 (COVID-19) is a worldwide pandemic challenge spreading enormously within a few months. COVID-19 is characterized by the over-activation of the immune system causing cytokine storm. Insulin-like growth factor-1 (IGF-1) pathway can regulate the immune response via interaction with various implicated cytokines. Heart-type fatty acid-binding protein (H-FABP) has been shown to promote inflammation. Given the fact that coronavirus infections induce cytokines secretion leading to inflammatory lung injury, it has been suggested that H-FABP levels are affected by COVID-19 severity. Moreover, endotrophin (ETP), the cleavage product of collagen VI, may be an indicator of an overactive repair process and fibrosis, considering that viral infection may predispose or exacerbate existing respiratory conditions, including pulmonary fibrosis. This study aims to assess the prognostic capacity of circulating IGF-1, HFABP, and ETP, levels for COVID-19 severity progression in Egyptian patients. The study cohort included 107 viral RNA-positive patients and an equivalent number of control individuals with no clinical signs of infection. Clinical assessments included profiling of CBC; serum iron; liver and kidney functions; inflammatory markers. Circulating levels of IGF-1; H-FABP, and ETP were estimated using the corresponding ELISA kits. No statistical difference in the body mass index was detected between the healthy and control groups, while the mean age of infected patients was significantly higher (P = 0.0162) than the control. Patients generally showed elevated levels of inflammatory markers including CRP and ESR concomitant with elevated serum ferritin; D dimer and procalcitonin levels, besides the COVID-19 characteristic lymphopenia and hypoxemia were also frequent. Logistic regression analysis revealed that oxygen saturation; serum IGF-1, and H-FABP can significantly predict the infection progression (P < 0.001 each). Both serum IGF-1 and H-FABP as well as O saturation showed remarkable prognostic potentials in terms of large AUC values, high sensitivity/specificity values, and wide confidence interval. The calculated threshold for severity prognosis was 25.5 ng/mL; 19.5 ng/mL, 94.5, % and for IGF-1, H-FABP, and O saturation; respectively. The calculated thresholds of serum IGF-1; H-FABP, and O saturation showed positive and negative value ranges of 79-91% and 72-97%; respectively, with 66-95%, 83-94% sensitivity, and specificity; respectively. The calculated cut-off values of serum IGF-1 and H-FABP represent a promising non-invasive prognostic tool that would facilitate the risk stratification in COVID-19 patients, and control the morbidity/mortality associated with progressive infection.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1743-422X 1743-422X
DOI:	10.1186/s12985-023-02057-4