Secretory Phospholipase A2 and Interleukin-6 Levels as Predictive Markers of the Severity and Outcome of Patients with COVID-19 Infections

Abstract

Coronavirus disease (COVID-19) has become a global pandemic. COVID-19 patients need immediate diagnosis and rehabilitation, which makes it urgent to identify new protein markers for a prognosis of the severity and outcome of the disease. The aim of this study was to analyze the levels of interleukin-6 (IL-6) and secretory phospholipase (sPLA2) in the blood of patients regarding the severity and outcome of COVID-19 infection. The study included clinical and biochemical data obtained from 158 patients with COVID-19 treated at St. Petersburg City Hospital No. 40. A detailed clinical blood test was performed on all patients, as well as an assessment of IL-6, sPLA2, aspartate aminotransferase (AST), total protein, albumin, lactate dehydrogenase (LDH), APTT, fibrinogen, procalcitonin, D-dimer, C-reactive protein (CRB), ferritin, and glomerular filtration rate (GFR) levels. It was found that the levels of PLA2, IL-6, APTV, AST, CRP, LDH, IL-6, D-dimer, and ferritin, as well as the number of neutrophils, significantly increased in patients with mild to severe COVID-19 infections. The levels of IL-6 were positively correlated with APTT; the levels of AST, LDH, CRP, D-dimer, and ferritin; and the number of neutrophils. The increase in the level of sPLA2 was positively correlated with the levels of CRP, LDH, D-dimer, and ferritin, the number of neutrophils, and APTT, and negatively correlated with the levels of GFR and lymphocytes. High levels of IL-6 and PLA2 significantly increase the risk of a severe course by 13.7 and 2.24 times, and increase the risk of death from COVID-19 infection by 14.82 and 5.32 times, respectively. We have shown that the blood levels of sPLA2 and IL-6 increase in cases which eventually result in death and when patients are transferred to the ICU (as the severity of COVID-19 infection increases), showing that IL-6 and sPLA2 can be considered as early predictors of aggravation of COVID-19 infections.

1-L Transcription of SARS-CoV-2 Spike Protein S1 Subunit

“…PLB1 phospholipase cleaves both sn-1 and sn-2 acyl chains and is active in human neutrophils, suggesting a role in the generation of lipid mediators of inflammation [106]. Furthermore, secretory phospholipase A2, which cleaves only the sn-2 acyl chain, is a predictive marker of the severity and outcome of COVID-19 patients [172]. GRB14 is a negative regulator of the insulin receptor [117].…”

“…However, USP24 promotion in M2 macrophages increases IL-6 transcription by stabilizing p300 and β-TrCP [164]. Increased IL-6 is a biomarker in COVID-19 [172]. Promoted LSAMP can induce the expression of the hippocampal mineralocorticoid receptor (MR) [50], and MR stimulation also promotes IL-6 expression [51].…”

“…Phospholipase A2 (PLA2) and IL-6 are predictive markers for the severity of COVID-19 [172]. PLA2 cleaves the sn-2 acyl chain to yield fatty acids and lysophospholipids, leading to the production of a wide variety of mediators that modulate immunity [181] and stimulate SARS-CoV-2 infection [182].…”

Coronavirus Disease Pathophysiology: Biomarkers, Potential New Remedies, Comorbidities, Long COVID-19, Post Pandemic Epidemiological Surveillance

“…The group of Stanislav Urazov et al from Russia and Israel [23] analyzed the levels of interleukin-6 (IL-6) and secretory phospholipase (sPLA2) in the blood samples of patients in relation to the severity and outcome of COVID-19. They showed that the levels of both IL-6 and sPLA2 could be early predictors of aggravation of COVID-19.…”