Abstract
Aims: We aimed to assess whether expression of whole-blood RNA of sodium proton exchanger 1 (NHE1) and glucose transporter 1 (GLUT1) is associated with COVID-19 infection and outcome in patients presenting to the emergency department with respiratory infections. Furthermore, we investigated NHE1 and GLUT1 expression in the myocardium of deceased COVID-19 patients.
Methods and results: Whole-blood quantitative assessment of NHE1 and GLUT1 RNA was performed using quantitative PCR in patients with respiratory infection upon first contact in the emergency department and subsequently stratified by SARS-CoV-2 infection status. Assessment of NHE1 and GLUT1 RNA using PCR was also performed in left ventricular myocardium of deceased COVID-19 patients. NHE1 expression is up-regulated in whole blood of patients with COVID-19 compared with other respiratory infections at first medical contact in the emergency department (control: 0.0021 ± 0.0002, COVID-19: 0.0031 ± 0.0003, P = 0.01). The ratio of GLUT1 to NHE1 is significantly decreased in the blood of COVID-19 patients who are subsequently intubated and/or die (severe disease) compared with patients with moderate disease (moderate disease: 0.497 ± 0.083 vs. severe disease: 0.294 ± 0.0336, P = 0.036). This ratio is even further decreased in the myocardium of patients who deceased from COVID-19 in comparison with the myocardium of non-infected donors.
Conclusions: NHE1 and GLUT1 may be critically involved in the disease progression of SARS-CoV-2 infection. We show here that SARS-CoV-2 infection critically disturbs ion channel expression in the heart. A decreased ratio of GLUT1/NHE1 could potentially serve as a biomarker for disease severity in patients with COVID-19.
Keywords: COVID-19; GLUT1; Heart; Infection; NHE1.
【저자키워드】 COVID-19, Infection, heart, GLUT1, NHE1., 【초록키워드】 respiratory infections, Biomarker, sodium, SARS-COV-2 infection, disease severity, progression, outcome, RNA, respiratory infection, PCR, Whole blood, Patient, donors, assessment, disease, expression, moderate, quantitative PCR, Glucose, COVID-19 patients, Blood, Deceased, severe disease, Contact, COVID-19 patient, Myocardium, Intubated, quantitative assessment, non-infected, performed, significantly, involved, investigated, the disease, was performed, other respiratory infection, presenting, up-regulated, stratified, patients with COVID-19, patients with moderate, ventricular, with COVID-19, 【제목키워드】 disease severity, Whole blood, predict, RNA expression, Decreased, patients with COVID-19,