Elevated Levels of Soluble CD147 are Associated with Hyperinflammation and Disease Severity in COVID-19: A Proof-of-Concept Clinical Study

To evaluate soluble CD147 levels in COVID-19 and identify whether these are associated with hyperinflammation and disease severity. One-hundred and nine COVID-19 patients and 72 healthy blood donors were studied. Levels of CD147, matrix metalloproteases (MMP) and inflammatory markers were measured on hospital arrival, while the need for mechanical ventilation and the occurrence of death during hospitalization were recorded. CD147 levels were higher in COVID-19 (1.6, 1.0–2.3 vs 1.3, 1.0–1.6 ng/ml; P = 0.003) than controls. MMP-2 (9.2, 4.5–12.9 vs 4.2, 3.7–4.6 ng/ml; P < 0.001), MMP-3 (1.1, 0.9–1.3 vs 0.9, 0.7–1.0 ng/ml; P < 0.001) and MMP-9 (0.9, 0.5–1.2 vs 0.4, 0.2–0.6 ng/ml; P < 0.001) were also higher in COVID-19, while MMP-1 (0.6, 0–1.4 vs 0.6, 0.3–0.7 ng/ml; P = 0.711) was not different. Significant correlations were found between CD147 and MMP-2 (ρ = 0.34), MMP-3 (ρ = 0.21), interleukin 6 (ρ = 0.21), and the neutrophil/lymphocyte ratio (ρ = 0.26). Furthermore, CD147 levels were higher in patients who required mechanical ventilation (1.8, 1.4–2.4 vs 1.2, 0.8–1.9 ng/ml; P < 0.001) and in those who ultimately died (1.9, 1.4–2.7 vs 1.4, 0.9–1.9 ng/ml; P = 0.009). CD147 is elevated in COVID-19 and appears to contribute to hyperinflammation and disease severity.