Sürfaktan Protein D Düzeyleri ile COVID-19 Klinik Şiddeti Arasındaki İlişkinin Değerlendirilmesi: Bir Vaka Kontrol Çalışması

Emre Karslı, Ramazan Sabirli, Tarık Gören, Aykut Kemanci, Denizhan Karış, İ̇brahim Türkçüer, Özgür Kurt, Aylin Koseler
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Abstract

Purpose: Serum surfactant protein D (SP-D) plays roles in the body such as protection against viral infection, bacterial and fungal clearance, clearance of apoptotic cells and suppression of inflammation. This study aims to examine the relationship between SP-D level and coronavirus disease (COVID-19) severity. Methods: 80 patients (30 with mild disease and 50 with severe/critical COVID-19), and 50 healthy volunteers were enrolled in the study. SP-D levels were analyzed by ELISA in serum samples. Results: The median of SP-D was found to be 2.47 (1.67-7.79) ng/ml in mild disease and 5.65 (3.09-16.55) ng/ml in severe/critical disease groups, while 2.89 (10.8-6.24) ng/ml in the healthy controls. The differences in SP-D levels between the severe/critical disease group compared to both mild disease and control groups were found statistically significant (p=0.007 and 0.001, respectively). ROC analysis showed greater AUC for the serum SP-D levels of the severe/critical COVID-19 patients compared to mild COVID-19 disease patients (AUC=0.691, 95% CI=0.56-0.822; p=0.004). Furthermore, SP-D levels were 86% sensitive and 51.6% specific at 2.44 ng/ml level (p=0.004) to detect severe/critical patients. Conclusion: SP-D levels is useful for COVID-19 patients in the prediction of clinical severity and prognosis. SP-D is a valuable biomarker for predicting the clinical severity and prognosis.
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目的:血清表面活性蛋白D (SP-D)在机体中具有抗病毒感染、清除细菌和真菌、清除凋亡细胞、抑制炎症等作用。本研究旨在探讨SP-D水平与冠状病毒病(COVID-19)严重程度的关系。方法:80例新冠肺炎患者(轻症患者30例,重/危重型患者50例)和健康志愿者50例。ELISA法检测血清中SP-D水平。结果:轻症组SP-D中位数为2.47 (1.67 ~ 7.79)ng/ml,重/危重症组SP-D中位数为5.65 (3.09 ~ 16.55)ng/ml,健康对照组SP-D中位数为2.89 (10.8 ~ 6.24)ng/ml。重症/危重症组SP-D水平与轻症组和对照组比较,差异均有统计学意义(p分别=0.007和0.001)。ROC分析显示,重症/危重型COVID-19患者血清SP-D水平的AUC高于轻症患者(AUC=0.691, 95% CI=0.56-0.822;p = 0.004)。在2.44 ng/ml水平下,SP-D检测重症/危重患者的敏感性为86%,特异性为51.6% (p=0.004)。结论:SP-D水平对COVID-19患者的临床严重程度及预后有预测价值。SP-D是预测临床严重程度和预后的有价值的生物标志物。
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