Abstract
Background
The role of programmed cell death, especially pyroptosis and apoptosis, in unfavorable immune responses in COVID-19 remains to be elucidated.
Methods
We conducted a cross-sectional analysis to investigate the association between the serum gasdermin D (GSDMD) levels, a pyroptotic marker, and caspase-cleaved cytokeratin 18 fragment (M30), an apoptotic marker, and the clinical status and abnormal chest computed tomography (CT) findings in patients with COVID-19.
Results
In this study, 46 patients diagnosed with COVID-19 were divided into the following three groups according to the disease severity: mild to moderate group (n = 10), severe group (n = 14), and critical group (n = 22). The serum GSDMD levels were higher in the critical group than in the mild to moderate group (P = 0.016). In contrast, serum M30 levels were lower in the critical group than in the severe group (P = 0.048). Patients who required mechanical ventilation or died had higher serum GSDMD levels than those who did not (P = 0.007). Area of consolidation only and of ground glass opacity plus consolidation positively correlated with serum GSDMD levels (r = 0.56, P < 0.001 and r = 0.53, P < 0.001, respectively).
Conclusion
Higher serum GSDMD levels are associated with critical respiratory status and the consolidation area on chest CT in patients with COVID-19, suggesting that excessive activation of pyroptosis may affect the clinical manifestations in patients with COVID-19.
【저자키워드】 COVID-19, Apoptosis, pyroptosis, gasdermin D, Caspase-cleaved cytokeratin 18 fragment, 【초록키워드】 immune response, mechanical ventilation, clinical status, Chest computed tomography, serum, Chest CT, Patient, Mild, Critical, moderate, consolidation, association, marker, clinical manifestation, programmed cell death, Ground glass opacity, severe group, cross-sectional analysis, apoptotic, Affect, GSDMD, Excessive activation, Result, died, the disease, required, conducted, Area, three group, diagnosed with COVID-19, patients with COVID-19, positively correlated, 【제목키워드】 Chest computed tomography, severity of COVID-19,