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. 2024 Jul 20;12(7):1618.
doi: 10.3390/biomedicines12071618.

The Impact of Pentraxin 3 Serum Levels and Angiotensin-Converting Enzyme Polymorphism on Pulmonary Infiltrates and Mortality in COVID-19 Patients

Zdravka Krivdić Dupan  1   2 , Vlatka Periša  2   3 , Mirjana Suver Stević  2   4 , Martina Mihalj  2   5 , Maja Tolušić Levak  2   5 , Silva Guljaš  1   2 , Tamer Salha  2   6 , Domagoj Loinjak  2   7 , Martina Kos  2   8 , Matej Šapina  2   8 , Ivana Canjko  9 , Mirela Šambić Penc  9 , Marin Štefančić  10 , Nenad Nešković  2   11
Affiliations

The Impact of Pentraxin 3 Serum Levels and Angiotensin-Converting Enzyme Polymorphism on Pulmonary Infiltrates and Mortality in COVID-19 Patients

Zdravka Krivdić Dupan et al. Biomedicines. .

Abstract

Objectives: The aim of this study was to examine the impact of the pentraxin 3 (PTX3) serum level and angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism on the severity of radiographic pulmonary infiltrates and the clinical outcomes of COVID-19.

Methods: The severity of COVID-19 pulmonary infiltrates was evaluated within a week of admission by analyzing chest X-rays (CXR) using the modified Brixia (MBrixa) scoring system. The insertion (I)/deletion (D) polymorphism of the ACE gene and the serum levels of PTX3 were determined for all patients included in the study.

Results: This study included 80 patients. Using a cut-off serum level of PTX3 ≥ 2.765 ng/mL, the ROC analysis (AUC 0.871, 95% CI 0.787-0.954, p < 0.001) showed a sensitivity of 85.7% and specificity of 78.8% in predicting severe MBrixa scores. Compared to ACE I/I polymorphism, D/D polymorphism significantly increased the risk of severe CXR infiltrates, OR 7.7 (95% CI: 1.9-30.1), and p = 0.002. Significant independent predictors of severe CXR infiltrates include hypertension (OR 7.71), PTX3 (OR 1.20), and ACE D/D polymorphism (OR 18.72). Hypertension (OR 6.91), PTX3 (OR 1.47), and ACE I/I polymorphism (OR 0.09) are significant predictors of poor outcomes.

Conclusion: PTX3 and ACE D/D polymorphism are significant predictors of the severity of COVID-19 pneumonia. PTX3 is a significant predictor of death.

Keywords: ACE polymorphism; COVID-19; MBrixia score; chest X-ray; pentraxin 3.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
ROC analysis of pentraxin-3 and age in predicting CXR infiltrate severity.
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