Abstract
Respiratory symptoms are one of COVID-19 manifestations, and the metalloproteinases (MMPs) have essential roles in the lung physiology. We sought to characterize the plasmatic levels of matrix metalloproteinase-2 and 9 (MMP-2 and MMP-9) in patients with severe COVID-19 and to investigate an association between plasma MMP-2 and MMP-9 levels and clinical outcomes and mortality. MMP-2 and MMP-9 levels in plasma from patients with COVID-19 treated in the ICU (COVID-19 group) and Control patients were measured with the zymography. The study groups were matched for age, sex, hypertension, diabetes, BMI, and obesity profile. MMP-2 levels were lower and MMP-9 levels were higher in a COVID-19 group (p < 0.0001) compared to Controls. MMP-9 levels in COVID-19 patients were not affected by comorbidity such as hypertension or obesity. MMP-2 levels were affected by hypertension (p < 0.05), but unaffected by obesity status. Notably, hypertensive COVID-19 patients had higher MMP-2 levels compared to the non-hypertensive COVID-19 group, albeit still lower than Controls (p < 0.05). No association between MMP-2 and MMP-9 plasmatic levels and corticosteroid treatment or acute kidney injury was found in COVID-19 patients. The survival analysis showed that COVID-19 mortality was associated with increased MMP-2 and MMP-9 levels. Age, hypertension, BMI, and MMP-2 and MMP-9 were better predictors of mortality during hospitalization than SAPS3 and SOFA scores at hospital admission. In conclusion, a significant association between MMP-2 and MMP-9 levels and COVID-19 was found. Notably, MMP-2 and MMP-9 levels predicted the risk of in-hospital death suggesting possible pathophysiologic and prognostic roles.
【저자키워드】 severe acute respiratory syndrome coronavirus 2, Coronavirus disease 2019, Acute kidney injury, angiotensin-converting enzyme 2, Angiotensin receptor blockers, renin-angiotensin system, angiotensin-converting enzyme inhibitors, Angiotensin-converting enzyme, angiotensin, COVID-19coronavirus disease 2019, SARS-CoV-2severe acute respiratory syndrome coronavirus 2, ACE2angiotensin-converting enzyme 2, SOFAsequential organ failure assessment score, sequential organ failure assessment score, RASRenin-angiotensin system, AKIAcute Kidney Injury, ACEiangiotensin-converting enzyme inhibitors, ACEangiotensin-converting enzyme, Angangiotensin, ARBangiotensin receptor blockers, iRAAsinhibitors of the renin-angiotensin system, inhibitors of the renin-angiotensin system, MMPsmetalloproteinases, metalloproteinases, MMP-9Matrix Metalloproteinase 9, Matrix Metalloproteinase 9, MMP-2Matrix Metalloproteinase 2, Matrix Metalloproteinase 2, SAPS3Simplified Acute Physiology Score III, Simplified Acute Physiology Score III, 【초록키워드】 COVID-19, Mortality, severe COVID-19, Hospitalization, obesity, lung, Comorbidity, Sex, risk, Symptom, diabetes, hypertension, ICU, Clinical outcome, survival, Patient, Control, Manifestations, plasma, age, Hospital admission, predictor, BMI, prognostic, respiratory, COVID-19 patients, association, Analysis, COVID-19 mortality, COVID-19 patient, SOFA score, In-hospital death, study group, COVID-19 group, metalloproteinase, corticosteroid treatment, predicted, affected, treated, not affected, were measured, hypertensive COVID-19 patient, pathophysiologic, patients with COVID-19, 【제목키워드】 Mortality, plasma, COVID-19 patient,