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Biology (Basel) . Clinical Relevance of Elevated Soluble ST2, HSP27 and 20S Proteasome at Hospital Admission in Patients with COVID-19

tetano

Editor, Senior Moderator
Biology (Basel)


. 2021 Nov 15;10(11):1186.
doi: 10.3390/biology10111186.
Clinical Relevance of Elevated Soluble ST2, HSP27 and 20S Proteasome at Hospital Admission in Patients with COVID-19


Ralph Wendt[SUP] 1 [/SUP], Marie-Therese Lingitz[SUP] 2 3 [/SUP], Maria Laggner[SUP] 2 [/SUP], Michael Mildner[SUP] 2 4 [/SUP], Denise Traxler[SUP] 2 5 [/SUP], Alexandra Graf[SUP] 6 [/SUP], Pavla Krotka[SUP] 6 [/SUP], Bernhard Moser[SUP] 2 7 [/SUP], Konrad Hoetzenecker[SUP] 7 [/SUP], Sven Kalbitz[SUP] 1 [/SUP], Christoph Lübbert[SUP] 1 8 [/SUP], Joachim Beige[SUP] 1 9 [/SUP], Hendrik Jan Ankersmit[SUP] 2 7 [/SUP]



Affiliations

Abstract

Although, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) represents one of the biggest challenges in the world today, the exact immunopathogenic mechanism that leads to severe or critical Coronavirus Disease 2019 (COVID-19) has remained incompletely understood. Several studies have indicated that high systemic plasma levels of inflammatory cytokines result in the so-called "cytokine storm", with subsequent development of microthrombosis, disseminated intravascular coagulation, and multiorgan-failure. Therefore, we reasoned those elevated inflammatory molecules might act as prognostic factors. Here, we analyzed 245 serum samples of patients with COVID-19, collected at hospital admission. We assessed the levels of heat shock protein 27 (HSP27), soluble suppressor of tumorigenicity-2 (sST2) and 20S proteasome at hospital admission and explored their associations with overall-, 30-, 60-, 90-day- and in-hospital mortality. Moreover, we investigated their association with the risk of ventilation. We demonstrated that increased serum sST2 was uni- and multivariably associated with all endpoints. Furthermore, we also identified 20S proteasome as independent prognostic factor for in-hospital mortality (sST2, AUC = 0.73; HSP27, AUC = 0.59; 20S proteasome = 0.67). Elevated sST2, HSP27, and 20S proteasome levels at hospital admission were univariably associated with higher risk of invasive ventilation (OR = 1.8; p < 0.001; OR = 1.1; p = 0.04; OR = 1.03, p = 0.03, respectively). These findings could help to identify high-risk patients early in the course of COVID-19.

Keywords: 20S proteasome; ARDS; COVID-19; HSP27; biomarker; sST2.
 
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