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. 2022 Feb 8:8:761299.
doi: 10.3389/fmed.2021.761299. eCollection 2021.

SP-D and CC-16 Pneumoproteins' Kinetics and Their Predictive Role During SARS-CoV-2 Infection

Margherita Tiezzi  1   2 , Sofia Morra  1   3 , Jimmy Seminerio  1 , Alain Van Muylem  4 , Audrey Godefroid  5 , Noémie Law-Weng-Sam  5 , Anne Van Praet  5 , Véronique Corbière  5 , Carmen Orte Cano  6 , Sina Karimi  7 , Véronique Del Marmol  6 , Benjamin Bondue  4 , Mariam Benjelloun  1   8 , Philomène Lavis  9 , Françoise Mascart  5   10 , Philippe van de Borne  1   3 , Alessandra K Cardozo  2
Affiliations

SP-D and CC-16 Pneumoproteins' Kinetics and Their Predictive Role During SARS-CoV-2 Infection

Margherita Tiezzi et al. Front Med (Lausanne). .

Abstract

Background: Surfactant protein D (SP-D) and pulmonary club cell protein 16 (CC-16) are called "pneumoproteins" and are involved in host defense against oxidative stress, inflammation, and viral outbreak. This study aimed to determine the predictive value of these pneumoproteins on the incidence of acute respiratory distress syndrome (ARDS) or death in patients with coronavirus disease-2019 (COVID-19).

Methods: This retrospective study included 87 patients admitted to an emergency department. Blood samples were collected on three time points (days 1, 5, and 14 from hospital admission). SP-D and CC-16 serum levels were determined, and univariate and multivariate analyses considering confounding variables (age, body mass index, tobacco use, dyspnea, hypertension, diabetes mellitus, neutrophil-to-lymphocyte ratio) were performed.

Results: Based on the multivariate analysis, SP-D level on D1 was positively and slightly correlated with subsequent development of ARDS, independent of body mass index, dyspnea, and diabetes mellitus. CC-16 level on D1 was modestly and positively correlated with fatal outcome. A rise in SP-D between D1 and D5 and D1 and D14 had a strong negative association with incidence of ARDS. These associations were independent of tobacco use and neutrophil-to-lymphocyte ratio.

Conclusions: Overall, our data reveal that increase in SP-D levels is a good prognostic factor for patients with COVID-19, and that initial CC-16 levels correlated with slightly higher risk of death. SP-D and CC-16 may prove useful to predict outcomes in patients with COVID-19.

Keywords: COVID-19; acute respiratory distress syndrome; biomarker; club cell 16 protein; prognosis; surfactant protein D.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of blood samples collected in this study. N, number of patients; D1, D5, and D14, days 1, 5, and 14 of hospitalization, respectively; O, outpatient; I, inpatient; ICU, intensive care unit; C, convalescent.
See this image and copyright information in PMC

References

    1. Thompson AB, Robbins RA, Romberger DJ, Sisson JH, Spurzem JR, Teschler H, et al. . Immunological functions of the pulmonary epithelium. Eur Respir J. (1995) 8:127–49. 10.1183/09031936.95.08010127 - DOI - PubMed
    1. Broeckaert F, Bernard A. Clara cell secretory protein (CC16): characteristics and perspectives as lung peripheral biomarker. Clin Exp Allergy. (2000) 30:469–75. 10.1046/j.1365-2222.2000.00760.x - DOI - PubMed
    1. Milne S, Li X, Hernandez Cordero AI, Yang CX, Cho MH, Beaty TH, et al. . Protective effect of club cell secretory protein (CC-16) on COPD risk and progression: a Mendelian randomisation study. Thorax. (2020) 75:934–43. 10.1136/thoraxjnl-2019-214487 - DOI - PubMed
    1. Zhai J, Insel M, Addison KJ, Stern DA, Pederson W, Dy A, et al. . Club cell secretory protein deficiency leads to altered lung function. Am J Respir Crit Care Med. (2019) 199:302–12. 10.1164/rccm.201807-1345OC - DOI - PMC - PubMed
    1. Hermans C, Petrek M, Kolek V, Weynand B, Pieters T, Lambert M, et al. . Serum Clara cell protein (CC16), a marker of the integrity of the air-blood barrier in sarcoidosis. Eur Respir J. (2001) 18:507–14. 10.1183/09031936.01.99102601 - DOI - PubMed