This study was undertaken due to the urgent need to explore reliable biomarkers for early SARS-CoV-2 infection. We performed a retrospective study analyzing the serum levels of the cardiovascular biomarkers IL-6, TNF-α, N-terminal pro-B natriuretic peptide, cardiac troponin T (cTnT), ischemia-modified albumin (IMA) and pregnancy-associated plasma protein-A (PAPP-A) in 84 patients with COVID-19.Patients were divided into three groups according to their RT-qPCR and IgG values: acute infection ( n = 35), early infection ( n = 25) or control subjects ( n = 24). Levels of biomarkers were analyzed in patient serum samples using commercially available ELISA kits. Results showed a significant increase in IMA and PAPP-A levels in the early infected patients. Moreover, multivariate analysis and receiver operating characteristic (ROC) curve showed that IMA and PAPP-A had excellent discrimination value for the early stage of COVID-19. For IMA, the area under the ROC curve (AUC) had a value of 0.94 (95% confidence interval (CI): 0.881–0.999). Likewise, the serum level of PAPP-A was significantly higher in patients with early infection than in the control subjects (AUC = 0.801 (95% CI: 0.673–0.929)). The combined use of IMA and PAPP-A enhanced the sensitivity for total SARS-CoV-2-infected patients to 93%. These results suggest that the increased levels of PAPP-A and IMA shed light on underlying mechanisms of COVID-19 physiopathology and might be used as efficient biomarkers with high sensitivity and specificity for the early stage of COVID-19. Importantly, when monitoring pregnancy and cardiovascular diseases using PAPP-A or IMA levels, a SARS-CoV-2 infection should be discarded for proper interpretation of the results.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Biomarkers, pregnancy-associated plasma protein-A, ischemia-modified albumin, 【초록키워드】 IgG, Biomarker, IL-6, SARS-COV-2 infection, peptide, cardiovascular disease, cardiac troponin, Retrospective study, sensitivity, RT-qPCR, Pregnancy, ROC, Sensitivity and specificity, acute infection, Patient, Interpretation, albumin, plasma, characteristic, early stage, mechanism, TNF-α, Analysis, early infection, ROC Curve, AUC, infected patients, Serum level, 95% confidence interval, significant increase, cTnT, serum sample, N-terminal, combined use, ELISA kits, Result, analyzed, performed, significantly higher, Level, three group, control subject, SARS-CoV-2-infected patient, 【제목키워드】 increase,