γ' Fibrinogen Levels as a Biomarker of COVID-19 Respiratory Disease Severity
21 Pages Posted: 11 Mar 2023
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by a pro-inflammatory state associated with organ failure, thrombosis, and death. We investigated a novel inflammatory biomarker, γ' fibrinogen (GPF), in 103 hospitalized patients with COVID-19 and 19 healthy controls. We found significant associations between GPF levels and the severity of COVID-19 as judged by blood oxygen saturation (SpO2). The mean level of GPF in the patients with COVID-19 was significantly higher than in controls (69.8 (95% CI 64.8-74.8) mg/dL compared with 36.9 (95% CI 31.4-42.4) mg/dL, p<0.0001), whereas C-reactive protein (CRP), lactate dehydrogenase (LDH), and total fibrinogen levels were not significantly different between groups. Mean GPF levels were significantly highest in patients with severe COVID-19 (SpO2 ≤93%, GPF 75.2 (95% CI 68.7-81.8) mg/dL), compared to mild/moderate COVID-19 (SpO2 >93%, GPF 62.5 (95% CI 55.0-70.0) mg/dL, p=0.01, AUC of 0.68, 95% CI 0.57-0.78; Youden's index cutpoint 62.9 mg/dL, sensitivity 0.64, specificity 0.63). In contrast, CRP, interleukin-6, ferritin, LDH, D-dimers, and total fibrinogen had weaker associations with COVID-19 disease severity (all ROC curves with lower AUCs). Thus, GPF may be a useful inflammatory marker of COVID-19 respiratory disease severity.
Note:
Funding Information: This research was funded by the National Institutes of Health's (NIH) National Institute of General Medical Sciences (NIGMS) under award K23GM130892-01 (L.Z.K.). This study was supported (in part) by research funding from Gamma Diagnostics, Inc. The authors acknowledge resources and support from the Micro Therapeutics Laboratory and Saveetha Medical College, Chennai, India.
Declaration of Interests: OHSU and David H. Farrell have a significant interest in Gamma Diagnostics, a company that may have a commercial interest in the results of this research and technology. This potential individual and institutional conflict of interest has been reviewed and managed by OHSU. Jamie Noll was the Chief Scientific Officer of Gamma Diagnostics, and Lucy Z. Kornblith is a scientific advisor to Gamma Diagnostics. None of the other authors declare any competing interests.
Ethics Approval Statement: This study was approved by the Institutional Ethical Committee at the Micro Therapeutics Laboratory, Chennai, India and Saveetha Medical College, Chennai, India. All participants provided written informed consent.
Keywords: biomarkers, COVID-19, disease progression, fibrinogen, respiratory distress syndrome
Suggested Citation: Suggested Citation