Evaluation of the relationship between surfactant protein D levels and COVID-19 clinical severity: a case-control study/ Surfaktan protein D duzeyleri ile COVID-19 klinik siddeti arasindaki iliskinin degerlendirilmesi: bir vaka kontrol calismasi

• Published in: Pamukkale Medical Journal 2023-01, Vol.16 (1), p.137
• Main Authors: Karsli, Emre, Sabirli, Ramazan, Goren, Tarik, Kemanci, Aykut, Karis, Denizhan, Turkcuer, Ibrahim, Kurt, Ozgur, Bertrand, Philippe, Koseler, Aylin
• Format: Article
• Language: English
• Subjects: Apoptosis; Bacterial pneumonia; Coronaviruses; Enzyme-linked immunosorbent assay; Health aspects; Inflammation; Pneumonia; Surface active agents
• ISSN: 1309-9833
• DOI: 10.31362/patd.1159512

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. Key words: Serum surfactant protein D, COVID-19, pneumonia. Amac: Serum surfaktan protein D (SP-D) vucutta viral enfeksiyona karsi koruma, bakteriyel ve fungal klirens, apoptotik hucrelerin temizlenmesi ve inflamasyonun baskilanmasi gibi roller oynar. Bu calisma, SP-D duzeyi ile koronavirus hastaligi (COVID-19) siddeti arasindaki iliskiyi incelemeyi amaclamaktadir. Gerec ve yontem: Calismaya 80 hasta (30 hafif hastaligi ve 50 agir/kritik COVID-19) ve 50 saglikli gonullu dahil edildi. Serum orneklerinde SP-D seviyeleri ELISA ile analiz edildi. Bulgular: SP-D duzeyi ortanca degeri hafif hastalikta 2,47 (1,67-7,79) ng/ml, agir/kritik hastalik gruplarinda 5,65 (3,09-16,55) ng/ml iken, saglikli control grubunda 2,89 (10,8-6,24) ng/ml olarak bulundu. Agir/kritik hastalik grubu hem hafif hastalik hem de kontrol grubu ile karsilastirildiginda SP-D duzeylerindeki farkliliklar istatistiksel olarak anlamli bulundu (sirasiyla p=0,007 ve 0,001). ROC analizi, hafif COVID-19 hastaligi hastalarina kiyasla siddetli/kritik COVID-19 hastalarinda serum SP-D seviyeleri icin egri altinda kalan alan daha