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Multicenter Study
. 2020 Nov;54(5):633-637.
doi: 10.1097/SHK.0000000000001562.

Serum Hydrogen Sulfide and Outcome Association in Pneumonia by the SARS-CoV-2 Coronavirus

Georgios Renieris  1 , Konstantina Katrini  1 , Christina Damoulari  1 , Karolina Akinosoglou  2 , Christos Psarrakis  1 , Magdalini Kyriakopoulou  3 , George Dimopoulos  4 , Malvina Lada  5 , Panagiotis Koufargyris  1 , Evangelos J Giamarellos-Bourboulis  1
Affiliations
Multicenter Study

Serum Hydrogen Sulfide and Outcome Association in Pneumonia by the SARS-CoV-2 Coronavirus

Georgios Renieris et al. Shock. 2020 Nov.

Abstract

Background: The pneumonia of COVID-19 illness has often a subtle initial presentation making mandatory the use of biomarkers for evaluation of severity and prediction of final patient disposition. We evaluated the use of hydrogen sulfide (H2S) for the outcome of COVID-19 pneumonia.

Patients and methods: We studied 74 patients with COVID-19. Clinical data were collected, and survival predictors were calculated. Blood was collected within 24 h after admission (day 1) and on day 7. H2S was measured in sera by monobromobimane derivation followed by high-performance liquid chromatography and correlated to other markers like procalcitonin and C-reactive protein (CRP). Tumor necrosis factor alpha and interleukin (IL)-6 were also measured in serum.

Results: Survivors had significantly higher H2S levels on days 1 and 7 after admission. A cut-off point of 150.44 μM could discriminate survivors from non-survivors with 80% sensitivity, 73.4% specificity, and negative predictive value 95.9%. Mortality after 28 days was 32% with admission levels lower than or equal to 150.44 μM and 4.1% with levels above 150.44 μM (P: 0.0008). Mortality was significantly greater among patients with a decrease of H2S levels from day 1 to day 7 greater than or equal to 36% (p: 0.0005). Serum H2S on day 1 was negatively correlated with IL-6 and CRP and positively correlated with the absolute lymphocyte count in peripheral blood.

Conclusion: It is concluded that H2S is a potential marker for severity and final outcome of pneumonia by the SARS-CoV-2 coronavirus. Its correlation with IL-6 suggests anti-inflammatory properties.

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Conflict of interest statement

Competing interests: E.J. Giamarellos-Bourboulis has received honoraria from AbbVie USA, Abbott CH, InflaRx GmbH, MSD Greece, XBiotech Inc. and Angelini Italy; independent educational grants from AbbVie, Abbott, Astellas Pharma Europe, AxisShield, bioMérieux Inc, InflaRx GmbH, and XBiotech Inc.; and funding from the FrameWork 7 program HemoSpec (granted to the National and Kapodistrian University of Athens), the Horizon2020 Marie-Curie Project European Sepsis Academy (granted to the National and Kapodistrian University of Athens), and the Horizon 2020 European Grant ImmunoSep (granted to the Hellenic Institute for the Study of Sepsis).

Figures

Fig. 1
Fig. 1
Hydrogen sulfide (H2S) as predictor for outcome of pneumonia by the SARS-CoV-2 coronavirus.
Fig. 2
Fig. 2
Association of hydrogen sulfide (H2S) on days 1 and 7 and white blood cell counts.
Fig. 3
Fig. 3
Hydrogen sulfide (H2S) as prognostic biomarker for pneumonia by the SARS-CoV-2 coronavirus.
See this image and copyright information in PMC

Comment in

  • To the Editor.
    Radermacher P, Calzia E, McCook O, Wachter U, Szabo C. Radermacher P, et al. Shock. 2021 Jan 1;55(1):138-139. doi: 10.1097/SHK.0000000000001602. Shock. 2021. PMID: 32590692 Free PMC article. No abstract available.

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