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Cell Death Dis . Low level of plasminogen increases risk for mortality in COVID-19 patients

tetano

Editor, Senior Moderator
Cell Death Dis


. 2021 Aug 5;12(8):773.
doi: 10.1038/s41419-021-04070-3.
Low level of plasminogen increases risk for mortality in COVID-19 patients


David Della-Morte[SUP] 1 2 3 4 [/SUP], Francesca Pacifici[SUP] 5 [/SUP], Camillo Ricordi[SUP] 6 [/SUP], Renato Massoud[SUP] 7 [/SUP], Valentina Rovella[SUP] 5 8 [/SUP], Stefania Proietti[SUP] 9 [/SUP], Mariannina Iozzo[SUP] 7 [/SUP], Davide Lauro[SUP] 5 8 [/SUP], Sergio Bernardini[SUP] 7 [/SUP], Stefano Bonassi[SUP] 10 9 [/SUP], Nicola Di Daniele[SUP] 5 8 [/SUP]



Affiliations

Abstract

The pathophysiology of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and especially of its complications is still not fully understood. In fact, a very high number of patients with COVID-19 die because of thromboembolic causes. A role of plasminogen, as precursor of fibrinolysis, has been hypothesized. In this study, we aimed to investigate the association between plasminogen levels and COVID-19-related outcomes in a population of 55 infected Caucasian patients (mean age: 69.8 ± 14.3, 41.8% female). Low levels of plasminogen were significantly associated with inflammatory markers (CRP, PCT, and IL-6), markers of coagulation (D-dimer, INR, and APTT), and markers of organ dysfunctions (high fasting blood glucose and decrease in the glomerular filtration rate). A multidimensional analysis model, including the correlation of the expression of coagulation with inflammatory parameters, indicated that plasminogen tended to cluster together with IL-6, hence suggesting a common pathway of activation during disease's complication. Moreover, low levels of plasminogen strongly correlated with mortality in COVID-19 patients even after multiple adjustments for presence of confounding. These data suggest that plasminogen may play a pivotal role in controlling the complex mechanisms beyond the COVID-19 complications, and may be useful both as biomarker for prognosis and for therapeutic target against this extremely aggressive infection.
 
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