Increase in Ischemia-Modified Albumin and Pregnancy-Associated Plasma Protein-A in COVID-19 Patients
Authors
Sánchez Gómez, Belén; Gasalla Herráiz, José Manuel; Sánchez Chapado, Manuel Vicente; Bort Bueno, Alicia Carmen; Díaz-Laviada Marturet, Inés CeciliaIdentifiers
Permanent link (URI): http://hdl.handle.net/10017/60397DOI: 10.3390/jcm10235474
ISSN: 0021-9738
Date
2021-11-23Affiliation
Universidad de Alcalá. Departamento de Cirugía, Ciencias Médicas y Sociales; Universidad de Alcalá. Departamento de Biología de Sistemas. Unidad Docente de Bioquímica y Biología MolecularFunders
Universidad de Alcalá
Comunidad de Madrid
Bibliographic citation
Journal of Clinical Investigation, 2021, v. 10, n. 23, p. 5474-
Keywords
Pregnancy-associated plasma protein-A
Ischemia-modified albumin
Biomarkers
COVID-19
SARS-CoV-2
Coronavirus
Description / Notes
12 p.
Project
info:eu-repo/grantAgreement/UAH//COVID-19 UAH 2019%00003%
016%001%001/ES//
info:eu-repo/grantAgreement/CM//REACT UE-CM2021-02/ES//
Document type
info:eu-repo/semantics/article
Version
info:eu-repo/semantics/publishedVersion
Rights
© 2021 by the authors
Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Access rights
info:eu-repo/semantics/openAccess
Abstract
This study was undertaken due to the urgent need to explore reliable biomarkers for early SARS-CoV-2 infection. We performed a retrospective study analyzing the serum levels of the cardiovascular biomarkers IL-6, TNF-?, N-terminal pro-B natriuretic peptide, cardiac troponin T (cTnT), ischemia-modified albumin (IMA) and pregnancy-associated plasma protein-A (PAPP-A) in 84 patients with COVID-19.Patients were divided into three groups according to their RT-qPCR and IgG values: acute infection (n = 35), early infection (n = 25) or control subjects (n = 24). Levels of biomarkers were analyzed in patient serum samples using commercially available ELISA kits. Results showed a significant increase in IMA and PAPP-A levels in the early infected patients. Moreover, multivariate analysis and receiver operating characteristic (ROC) curve showed that IMA and PAPP-A had excellent discrimination value for the early stage of COVID-19. For IMA, the area under the ROC curve (AUC) had a value of 0.94 (95% confidence interval (CI): 0.881-0.999). Likewise, the serum level of PAPP-A was significantly higher in patients with early infection than in the control subjects (AUC = 0.801 (95% CI: 0.673-0.929)). The combined use of IMA and PAPP-A enhanced the sensitivity for total SARS-CoV-2-infected patients to 93%. These results suggest that the increased levels of PAPP-A and IMA shed light on underlying mechanisms of COVID-19 physiopathology and might be used as efficient biomarkers with high sensitivity and specificity for the early stage of COVID-19. Importantly, when monitoring pregnancy and cardiovascular diseases using PAPP-A or IMA levels, a SARS-CoV-2 infection should be discarded for proper interpretation of the results.
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