RT Journal Article
SR Electronic
T1 Prognostic significance of complement factors in severely ill patients with COVID-19
JF Journal of Investigative Medicine
JO J Investig Med
FD BMJ Publishing Group Ltd
SP jim-2021-002224
DO 10.1136/jim-2021-002224
A1 Asmaa E Hassan
A1 Mai M Fahmy
A1 Dalia E Sherif
A1 Eman M Habib
A1 Mohammed H Ahmed
A1 Nahla A Nosair
A1 Nahla Farahat
YR 2022
UL http://hw-f5-jim.highwire.org/content/early/2022/08/08/jim-2021-002224.abstract
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.