PT  - JOURNAL ARTICLE
AU  - Asmaa E Hassan
AU  - Mai M Fahmy
AU  - Dalia E Sherif
AU  - Eman M Habib
AU  - Mohammed H Ahmed
AU  - Nahla A Nosair
AU  - Nahla Farahat
TI  - Prognostic significance of complement factors in severely ill patients with COVID-19
AID  - 10.1136/jim-2021-002224
DP  - 2022 Aug 08
TA  - Journal of Investigative Medicine
PG  - jim-2021-002224
4099  - http://hw-f5-jim.highwire.org/content/early/2022/08/08/jim-2021-002224.short
4100  - http://hw-f5-jim.highwire.org/content/early/2022/08/08/jim-2021-002224.full
AB  - Coagulopathy, cytokine release, platelet hyperactivity and endothelial activation are regarded as potential major contributors to COVID-19 morbidity. Complement activation might provide a bridge linking these factors in severe COVID-19 illness. In this study, we investigated the prognostic significance of selected complement factors in hospitalized patients with severe COVID-19 infection. The study included 300 hospitalized adults with severe COVID-19 infection. Complement factors (C3, C3a, C4, sC5b-9) were assessed by commercial ELISA kits. Outcome parameters included mortality, intensive care unit admission and duration of hospital stay. It was found that survivors had significantly higher serum C3 (median (IQR): 128.5 (116.3–141.0) mg/dL vs 98.0 (70.0–112.8) mg/dL, p<0.001) and C4 (median (IQR): 36.0 (30.0–42.0) mg/dL vs 31.0 (26.0–35.0) mg/dL, p<0.001) levels when compared with non-survivors. On the other hand, it was shown that survivors had significantly lower C3a (median (IQR): 203.0 (170.3–244.0) ng/mL vs 385.0 (293.0–424.8) ng/mL, p<0.001) and sC5b-9 (median (IQR): 294.0 (242.0–318.8) ng/mL vs 393.0 (342.0–436.5) ng/mL, p<0.001) levels when compared with non-survivors. Multivariate logistic regression analysis identified C3a (OR: 0.97 (95% CI 0.96 to 0.99), p<0.001) and C4 (OR: 0.92 (95% CI 0.86 to 0.98), p=0.011) levels as significant predictors of mortality. In conclusion, serum levels of complement factors are related to mortality in severely ill patients with COVID-19.Data are available upon reasonable request.