Secretory phospholipase 2 (sPLA2) acts as a mediator between proximal and distal events of the inflammatory cascade. Its role in SARS-CoV-2 infection is unknown, but could contribute to COVID-19 inflammasome activation and cellular damage. We present the first report of plasma sPLA2 levels in adults and children with COVID-19 compared with controls. Currently asymptomatic adults with a history of recent COVID-19 infection (≥4 weeks before) identified by SARS-CoV-2 IgG antibodies had sPLA2 levels similar to those who were seronegative (9 ± 6 vs.17 ± 28 ng/mL, P = 0.26). In contrast, children hospitalized with severe COVID-19 had significantly elevated sPLA2 compared with those with mild or asymptomatic SARS-CoV-2 infection (269 ± 137 vs. 2 ± 3 ng/mL, P = 0.01). Among children hospitalized with multisystem inflammatory syndrome in children (MIS-C), all had severe disease requiring pediatric intensive care unit (PICU) admission. sPLA2 levels were significantly higher in those with acute illness <10 days versus convalescent disease ≥10 days (540 ± 510 vs. 2 ± 1, P = 0.04). Thus, sPLA2 levels correlated with COVID-19 severity and acute MIS-C in children, implicating a role in inflammasome activation and disease pathogenesis. sPLA2 may be a useful biomarker to stratify risk and guide patient management for children with acute COVID-19 and MIS-C. Therapeutic compounds targeting sPLA2 and inflammasome activation warrant consideration.
【저자키워드】 COVID-19, multisystem inflammatory syndrome in children, SARS-CoVC-2, secretory phospholipase A2, 【초록키워드】 Biomarker, Hospitalized, intensive care, severe COVID-19, SARS-COV-2 infection, pediatric, children, severity, COVID-19 severity, risk, MIS-C, Asymptomatic, COVID-19 infection, IgG antibodies, SARS-CoV-2 IgG antibody, management, Patient, Mild, plasma, convalescent, Patient management, disease, Admission, seronegative, Inflammatory, severe disease, mediator, disease pathogenesis, Compound, SARS-CoV-2 IgG antibodies, syndrome, cellular damage, inflammasome activation, acute COVID-19, acute illness, inflammatory cascade, secretory, controls, event, significantly, elevated, contribute, correlated, significantly higher, proximal, children with COVID-19, distal, with COVID-19, 【제목키워드】 children, Phospholipase A2, Inflammatory, syndrome, secretory,