Annexin A1 as a potential prognostic biomarker for COVID‐19 disease: Case–control study

Abstract

Background Annexin A1 (AnxA1) is an important endogenous glucocoticoid protein that contributes to the suppression of inflammation by limiting the production of neutrophil and pro‐inflammatory cytokines. This study aims to determine the clinical predictivity value of blood AnxA1 levels in patients with mild and severe–critical pneumonia induced by COVID‐19. Methods This study employed a prospective, case–control study design and was conducted at Ankara Training and Research hospital between 10 February 2021 and 15 March 2021. A total of 74 patients (42 of whom had moderate and 32 of whom had severe/critical cases of COVID‐19 disease according to World Health Organization guidelines) and 50 nonsymptomatic healthy volunteers participated in the study. Blood samples were taken from patients at the time of hospital admission, after which serum was isolated. Following the isolation of serum, AnxA1 levels were evaluated using the enzyme‐linked immunosorbent assay method. Results The serum AnxA1 levels were measured as 25.5 (18.6‐38.6) ng/ml in the control group, 21.2 (14.7‐32) ng/ml in the moderate disease group, and 14.8 (9.7‐26.8) ng/ml in the severe/critical disease group. Serum AnxA1 levels were significantly lower in the severe/critical disease group compared with the control and moderate disease groups ( P = .01 and P = .0001, respectively). Using receiver operating characteristic analysis, a larger area under the curve (AUC) for the serum AnxA1 levels of the control group (AUC = 0.715, 95% CI = 0.626‐0.803; P = .0001) was calculated compared with the COVID‐19 patient group for the diagnosis of COVID‐19 disease. The AnxA1 level was found to be 80% sensitive and 54.1% specific at a cut‐off level of 18.5 ng/ml for the diagnosis of COVID‐19 disease. Moreover, the AnxA1 level was found to be 69.8% sensitive and 58.1% specific at a cut‐off level of 17.2 ng/ml in predicting the need for intensive care unit (ICU) treatment. Conclusion AnxA1 levels may be a beneficial biomarker in the diagnosis of COVID‐19 pneumonia and in predicting the need for ICU treatment in patients with COVID‐19 pneumonia at the time of admission to the emergency department.

Biologically informed deep learning to query gene programs in single-cell atlases

“…Annexins are structural proteins that participate in the regulation of inflammatory responses and homeostasis 67 and have been associated with disease severity in COVID-19 (refs. 68 , 69 ). In this circuit, CD14 + and CD16 + monocytes show the potential to receive signals from NK cells and CD8 + T cells for P1D1.…”

“…Although expression levels of annexins have been described as biomarkers for the prediction of disease severity 69 , our analysis using expiMap is the first to describe the expression of ligand–receptor pairs from the annexin pathway at the cellular level with the potential to interact between monocytes (CD14 + and CD16 + ), NK cells and T cells in COVID. The differences observed between patients in the expression of annexin-related interaction circuits may be related to the capability of viral clearance in each patient 62 and the early expression of FPR1 by CD16 + monocytes, which is associated with the early detection of pathogenic molecules and tissue damage 70 .…”

Biologically informed deep learning to infer gene program activity in single cells

“…5f and Supplementary Fig. 11 ).Annexins are structural proteins that participate in multiple processes, including the regulation of inflammatory responses and homeostasis 61 ; recently, they have been associated with the disease severity of COVID-19 in patients requiring hospitalization 62,63 . In this circuit, CD14 + and CD16 + monocytes receive signals from NK cells and CD8 + T cells for P1D1, whereas for P1D5, the annexin circuit switches completely to signaling between CD16 + monocytes and CD4 + T cells.…”

“…Although expression levels of annexins have been described as biomarkers for the prediction of disease severity 63 , our analysis using expiMap is the first to describe the annexin circuit at the cellular level between monocytes (CD14 + and CD16 + ), NK cells, and T cells in COVID. The differences observed between patients in the expression of annexin-related interaction circuits may be related to the capability of viral clearance in each patient 56 and the early expression of FPR1 by CD16 + monocytes, which is associated with the early detection of pathogenic molecules and tissue damage 64 .…”

Annexin‐A1: The culprit or the solution?

“…Moreover, serum ANXA1 levels predicted a poor outcome 6 months after aSAH occurance [ 114] . Interestingly, a recent COVID‐19 study has shown that serum ANXA1 levels were significantly lower in samples from patients with severe disease compared to both healthy controls and those with moderate disease [ 115] . This suggests a potential role of ANXA1 as a biomarker in predicting COVID‐19 prognosis, which could allow for earlier treatment interventions.…”