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Current Respiratory Medicine Reviews

Author(s): Mitra Samareh Fekri*, Elham Barfzade, Mehrdad Farokhnia, Seyed Mehdi Hashemi Bajgani, Ahmad Shafahi, Mohsen Shafiepour, Sajjadeh Movahedinia, Shariar Dabiri and Meysam Yousefi

DOI: 10.2174/1573398X18666220210145349

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Investigating COVID-19 Severity Based on Serum Apelin-17 Levels and Inflammatory Mediators

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Abstract

Background: COVID-19 is an infectious disease caused by SARS-CoV-2 and can lead to acute respiratory distress.

Objective: We aimed to investigate the association between COVID-19 severity and serum apelin- 17 and inflammatory mediator levels.

Methods: This cross-sectional study was conducted on patients with COVID-19. COVID-19 infection was confirmed by the RT-PCR test. The patients' data were extracted from their records. Venous blood samples were obtained from the patients to investigate the serum levels of apelin-17 and inflammatory mediators.

Results: Eighty-six COVID-19 patients were studied. The mean age of the participants was 55.56±14.88, and 43 (50 %) were male. Clinical symptoms were dyspnea 77.6 %, fever 52.3 %, cough 48.8 %, gastrointestinal symptoms 15.1 %, and chest pain 7 %. The overall mortality rate was 7 %. No significant relationship was found between serum apelin-17 levels and COVID-19 severity (P= 0.48). However, there was a significant and direct relationship between COVID-19 severity and serum levels of CRP (P= 0.038) and D-dimer (P= 0.029).

Conclusion: Serum apelin-17 levels were higher in recovered patients than those who died (4.90 vs. 3.19). Moreover, serum apelin-17 levels were higher in the patients admitted to the general ward than those admitted to the ICU (5.15 vs. 3.98). The difference was not statistically significant. However, there was a significant and direct relationship between serum apelin-17 levels and lymphocyte count (P= 0.022). Moreover, there was a significant and inverse relationship between lymphocyte count and COVID-19 severity (P= 0.004). Therefore, it can be interpreted that COVID-19 severity may decrease with an increase in serum apelin-17 levels. Therefore, to prove this hypothesis, a study with larger sample size is recommended.

Keywords: Severity, COVID-19, Apelin, D-dimer, C-reactive protein, pneumonia.

Graphical Abstract

[1]
Zhou P, Yang X-L, Wang X-G, et al. Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin. BioRxiv 2020.
[http://dx.doi.org/10.1101/2020.01.22.914952]
[2]
WHO. Q&A on coronaviruses (COVID-19): World Health Organization 2020. 2020. Available from: who. int/news-room/qadetail/qa-coronaviruses
[3]
CDC. Symptoms of Novel Coronavirus (2019-nCoV) 2020. 2020. Available from: www.cdc.gov
[4]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[5]
Li LQ, Huang T, Wang YQ, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020; 92(6): 577-83.
[http://dx.doi.org/10.1002/jmv.25757] [PMID: 32162702]
[6]
Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med 2020; 58(7): 1131-4.
[http://dx.doi.org/10.1515/cclm-2020-0198] [PMID: 32119647]
[7]
Tatemoto K, Hosoya M, Habata Y, et al. Isolation and characterization of a novel endogenous peptide ligand for the human APJ receptor. Biochem Biophys Res Commun 1998; 251(2): 471-6.
[http://dx.doi.org/10.1006/bbrc.1998.9489] [PMID: 9792798]
[8]
De Falco M, De Luca L, Onori N, et al. Apelin expression in normal human tissues. in vivo-athens 2002; 16(5): 333-6.
[PMID: 12494873]
[9]
Trayhurn P, Bing C, Wood IS. Adipose tissue and adipokines-- energy regulation from the human perspective. J Nutr 2006; 136(7)(Suppl.): 1935S-9S.
[http://dx.doi.org/10.1093/jn/136.7.1935S] [PMID: 16772463]
[10]
Szokodi I, Tavi P, Földes G, et al. Apelin, the novel endogenous ligand of the orphan receptor APJ, regulates cardiac contractility. Circ Res 2002; 91(5): 434-40.
[http://dx.doi.org/10.1161/01.RES.0000033522.37861.69] [PMID: 12215493]
[11]
Japp AG, Cruden NL, Amer DA, et al. Vascular effects of apelin in vivo in man. J Am Coll Cardiol 2008; 52(11): 908-13.
[http://dx.doi.org/10.1016/j.jacc.2008.06.013] [PMID: 18772060]
[12]
Chong KS, Gardner RS, Morton JJ, Ashley EA, McDonagh TA. Plasma concentrations of the novel peptide apelin are decreased in patients with chronic heart failure. Eur J Heart Fail 2006; 8(4): 355-60.
[http://dx.doi.org/10.1016/j.ejheart.2005.10.007] [PMID: 16464638]
[13]
Kleinz MJ, Skepper JN, Davenport AP. Immunocytochemical localisation of the apelin receptor, APJ, to human cardiomyocytes, vascular smooth muscle and endothelial cells. Regul Pept 2005; 126(3): 233-40.
[http://dx.doi.org/10.1016/j.regpep.2004.10.019] [PMID: 15664671]
[14]
Pozo Devoto VM, Bogetti ME, Fiszer de Plazas S. Developmental and hypoxia-induced cell death share common ultrastructural and biochemical apoptotic features in the central nervous system. Neuroscience 2013; 252: 190-200.
[http://dx.doi.org/10.1016/j.neuroscience.2013.07.065] [PMID: 23933309]
[15]
Zhang J, Liu Q, Fang Z, et al. Hypoxia induces the proliferation of endothelial progenitor cells via upregulation of Apelin/APLNR/MAPK signaling. Mol Med Rep 2016; 13(2): 1801-6.
[http://dx.doi.org/10.3892/mmr.2015.4691] [PMID: 26676468]
[16]
Ahnach M, Zbiri S, Nejjari S, Ousti F, Elkettani C. C-reactive protein as an early predictor of COVID-19 severity. J Med Biochem 2020; 39(4): 500-7.
[http://dx.doi.org/10.5937/jomb0-27554] [PMID: 33312067]
[17]
WHO. Clinical management of COVID-19 (Interim guidance). 2020. Available from: www.who.int/publications/i/item/clinicalmanagement-of-covid-19
[18]
Covid 19 diagnosis and treatment guidance- in outpatient and inpatient service Levels 2020. 2020. Available from: https://www.behdasht.gov.ir
[19]
Masri B, Knibiehler B, Audigier Y. Apelin signalling: a promising pathway from cloning to pharmacology. Cell Signal 2005; 17(4): 415-26.
[http://dx.doi.org/10.1016/j.cellsig.2004.09.018] [PMID: 15601620]
[20]
Kleinz MJ, Davenport AP. Emerging roles of apelin in biology and medicine. Pharmacol Ther 2005; 107(2): 198-211.
[http://dx.doi.org/10.1016/j.pharmthera.2005.04.001] [PMID: 15907343]
[21]
Kawamata Y, Habata Y, Fukusumi S, et al. Molecular properties of apelin: tissue distribution and receptor binding. Biochim Biophys Acta 2001; 1538(2-3): 162-71.
[http://dx.doi.org/10.1016/S0167-4889(00)00143-9] [PMID: 11336787]
[22]
Zhang H, Chen S, Zeng M, et al. Apelin-13 administration protects against LPS-induced acute lung injury by inhibiting NF-κB pathway and NLRP3 inflammasome activation. Cell Physiol Biochem 2018; 49(5): 1918-32.
[http://dx.doi.org/10.1159/000493653] [PMID: 30235451]
[23]
He L, Xu J, Chen L, Li L. Apelin/APJ signaling in hypoxia-related diseases. Clin Chim Acta 2015; 451(Pt B): 191-8.
[http://dx.doi.org/10.1016/j.cca.2015.09.029] [PMID: 26436483]
[24]
Kleinz MJ, Davenport AP. Immunocytochemical localization of the endogenous vasoactive peptide apelin to human vascular and endocardial endothelial cells. Regul Pept 2004; 118(3): 119-25.
[http://dx.doi.org/10.1016/j.regpep.2003.11.002] [PMID: 15003827]
[25]
Fan X-F, Xue F, Zhang Y-Q, et al. The Apelin-APJ axis is an endogenous counterinjury mechanism in experimental acute lung injury. Chest 2015; 147(4): 969-78.
[http://dx.doi.org/10.1378/chest.14-1426] [PMID: 25375801]
[26]
Chi Y, Chai J, Xu C, Luo H, Zhang Q. Apelin inhibits the activation of the nucleotide-binding domain and the leucine-rich, repeat-containing family, pyrin-containing 3 (NLRP3) inflammasome and ameliorates insulin resistance in severely burned rats. Surgery 2015; 157(6): 1142-52.
[http://dx.doi.org/10.1016/j.surg.2015.01.011] [PMID: 25817096]
[27]
Visser YP, Walther FJ, Laghmani H. Laarse Av, Wagenaar GT. Apelin attenuates hyperoxic lung and heart injury in neonatal rats. Am J Respir Crit Care Med 2010; 182(10): 1239-50.
[http://dx.doi.org/10.1164/rccm.200909-1361OC] [PMID: 20622042]
[28]
Machura E, Ziora K, Ziora D, et al. Serum apelin-12 level is elevated in schoolchildren with atopic asthma. Respir Med 2013; 107(2): 196-201.
[http://dx.doi.org/10.1016/j.rmed.2012.10.026] [PMID: 23199840]
[29]
Wagner J, DuPont A, Larson S, Cash B, Farooq A. Absolute lymphocyte count is a prognostic marker in Covid-19: A retrospective cohort review. Int J Lab Hematol 2020; 42(6): 761-5.
[http://dx.doi.org/10.1111/ijlh.13288] [PMID: 32779838]
[30]
Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost 2020; 18(6): 1324-9.
[http://dx.doi.org/10.1111/jth.14859] [PMID: 32306492]
[31]
Khosravi B, Aghaghazvini L, Sorouri M, et al. Predictive value of initial CT scan for various adverse outcomes in patients with COVID-19 pneumonia. Heart Lung 2021; 50(1): 13-20.
[http://dx.doi.org/10.1016/j.hrtlng.2020.10.005] [PMID: 33097297]
[32]
Nguyen NT, Chinn J, Nahmias J, et al. Outcomes and mortality among adults hospitalized with COVID-19 at US medical centers. JAMA Network Open 2021; 4(3): e210417-e.