Serum Neopterin Levels and the Clinical Presentation of COVID-19 (original) (raw)

Serum neopterin levels in relation to mild and severe COVID-19

BackgroundThe COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, is rapidly spreading worldwide. There is limited information about prognostic markers that could help clinicians to identify COVID-19 patients with a poor prognosis. Serum levels of the immune activation marker neopterin has shown to be of prognostic value in patients with SARS. The aim of this study was to investigate whether serum neopterin is associated with the severity of COVID-19.MethodsWe included 34 patients with confirmed COVID-19 between March 3 and March 30, 2020. Fifteen patients had mild disease and did not require hospitalization, whereas 19 patients developed severe COVID-19 requiring intensive care. Concentrations of serum neopterin, tryptophan, and kynurenine were measured at and repeatedly after inclusion.ResultsWe found a more than two-fold higher mean concentration of neopterin in severely ill patients (mean value 42.0 nmol/L (SD 18.2)) compared to patients with mild symptoms (16.9 nmol/L (SD ...

Neopterin Predicts Disease Severity in Hospitalized Patients With COVID-19

Open Forum Infectious Diseases, 2020

This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with coronavirus disease 2019 (COVID-19). Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for intensive care unit admission, need for mechanical ventilation, and death. Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients.

Neopterin: A Promising Candidate Biomarker for Severe COVID-19

Journal of Inflammation Research, 2021

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has rapidly spread across the world since its first emergence in China in late 2019. It is a major public health concern with no effective treatct 3ments. The immunopathology of SARS-CoV-2 is associated with an excessive inflammatory response. Macrophage activation syndrome (MAS) is also associated with the severity of the disease in SARS-CoV-2-infected patients. Neopterin is a macrophage activation marker produced by monocytes and macrophages upon activation by interferon-gamma (IFN-γ). Neopterin is a well-established marker in a variety of diseases, and recent evidence indicates that it could be helpful in early prediction of the severity of COVID-19 disease and serve as a prognostic marker. Here, we outline the role of macrophage activation syndrome in the pathogenesis of SARS-CoV-2 and suggest that neopterin could be used as a biomarker for progression of COVID-19.

The potential role of neopterin in Covid-19: a new perspective

Molecular and Cellular Biochemistry

Neopterin (NPT) is a member of pteridines group, synthesized by macrophages when stimulated by interferon gamma (INFγ). NPT is regarded as a macrophage stimulation indicator, marker of cellular immune activation and T helper 1 (Th1) type 1 immune response. Here, we aimed to provide a view point on the NPT features and role in Covid-19. Serum NPT level is regarded as an independent prognostic factor for Covid-19 severity, with levels starting to increase from the 3rd day of SARS-CoV-2 infection, being associated with severe dyspnea, longer hospitalization period and complications. Also, early raise of NPT reflects monocytes/macrophages activation before antibody immune response, despite the NPT level may also remain high in Covid-19 patients or at the end of incubation period before the onset of clinical symptoms. On the other hand, NPT attenuates the activity of macrophage foam cells and is linked to endothelial inflammation through inhibition of adhesion molecules and monocytes migration. However, NPT also exerts anti-inflammatory and antioxidant effects by suppressing NF-κB signaling and NLRP3 inflammasomes. NPT can be viewed as a protective compensatory mechanism to counterpoise hyper-inflammation, oxidative stress, and associated organ damage.

Biomarkers Analysis of COVID-19 Patients: Lessons Learnt from the Deadly Pandemic

SSR Institute of International Journal of Life Sciences, 2024

Background: Coronavirus disease-2019 (COVID-19) manifests as inflammation, leading to a raised level of associated biomarkers, which assists in risk stratification. We investigated the correlation between demography and biomarkers, namely, Interleukin-6 (IL-6), serum C-reactive protein (CRP), D-dimer, procalcitonin (PCT), and serum ferritin with prognosis among COVID-19 patients. Method: This is a retrospective cohort study conducted on COVID-19 patients amidst the second wave of the pandemic. IL-6, PCT, serum ferritin, CRP, and D-dimer levels were analyzed among patients diagnosed as COVID-positive by real-time polymerase chain reaction. Result: Out of 1663 patients included in this study, 65% were males, with the median age of the study population being 48 years. The mean levels of IL-6, ferritin, CRP, and PCT were significantly raised in the older age group (47-95 years) than the younger population (4-46 years), whereas D-dimer was found to be raised in all age groups. The mortality rate was 5% (median age-59 years), with males showing high severity and a mortality rate 67.4%. Conclusion: Evaluating and tracking the biomarkers at the outset of the disease has been proven to give a substantial edge in assessing disease prognosis and preventing mortality. Henceforth, they become the guiding force for management strategies in this era of precision medicine.

Co-relation between inflammatory biomarkers and COVID-19 progression

International Journal of Health Sciences (IJHS), 2022

Background & Objective:-Coronavirus Disease-19 (COVID-19) disease has caused considerable morbidity and mortality worldwide. The present study aims to investigate the prognostic significance of the inflammatory markers and to augment our present knowledge of these biomarkers to help in risk stratification. Methodology-The proposed study is a retrospective observational study on COVID-19 positive patients admitted in the ICU of Hospital of Government Doon Medical College, Dehradun, India from November 2020 to January 2021. Patients were categorized in to three groups moderate, severe and critical as per the criteria mentioned in methodology section in detail. Statistical Analysis-To explore the risk factors associated with illness severity of COVID-19, we categorized the patients into two groups, and one is moderate and severe and second is critical. Potential predictive variables included the following case characteristics on admission: demographic features and, comorbidity, clinical signs and symptoms and laboratory findings. Results-Sixty-two patients were enrolled in this study with mean age of 63.24±20.12 of which 44(70.96%) were males and 18(29.03%) were females. Multiple number of patients had comorbidities with diabetes 36(58.06%) patients, followed by hypertension in 24(38.70%). Conclusion-Single prognostic inflammatory marker indicating the progression to disease severity early in disease timeline is the Creactive protein. Neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR) with CRP together can have a good predictability of disease outcome.

Neopterin as a Marker for Immune System Activation

Current Drug Metabolism, 2002

Increased amounts of neopterin are produced by human monocytes/macrophages upon stimulation with the cytokine interferon-γ. Therefore, measurement of neopterin concentrations in body fluids like serum, cerebrospinal fluid or urine provides information about activation of T helper cell 1 derived cellular immune activation. Increased neopterin production is found in infections by viruses including human immunodeficiency virus (HIV), infections by intracellular living bacteria and parasites, autoimmune diseases, malignant tumor diseases and in allograft rejection episodes. But also in neurological and in cardiovascular diseases cellular immune activation indicated by increased neopterin production, is found.

C-Reactive Protein a Promising Biomarker of COVID-19 Severity

Korean Journal of Clinical Laboratory Science, 2021

The 2019 coronavirus outbreak poses a threat to scientific, societal, financial, and health resources. The complex pathogenesis of severe acute respiratory syndrome coronavirus centers on the unpredictable clinical progression of the disease, which may evolve abruptly and result in critical and life-threatening clinical complications. Effective clinical laboratory biomarkers that can classify patients according to risk are essential for ensuring timely treatment, and an analysis of recently published studies found cytokine storm and coagulation disorders were leading factors of severe COVID-19 complications. The following inflammatory, biochemical, and hematology biomarkers markers have been identified in COVID-19 patients; neutrophil to lymphocyte ratio, c-reactive protein, procalcitonin, urea, liver enzymes, lactate dehydrogenase, serum amyloid A, cytokines, d-dimer, fibrinogen, ferritin, troponin, creatinine kinase, and lymphocyte, leukocyte, and platelet counts. These factors are predictors of disease severity and some are involved in the pathogenesis of COVID-19. CRP is an acute-phase, non-specific serological biomarker of inflammation and infection and is related to disease severities and outcomes. In the present study, CRP levels were found to rise dramatically among COVID-19 patients, and our findings suggest CRP could be utilized clinically to predict COVID-19 prognosis and severity even before disease progression and the manifestation of clinical symptoms.

Role of Polypeptide Inflammatory Biomarkers in the Diagnosis and Monitoring of COVID-19

International Journal of Peptide Research and Therapeutics, 2022

The COVID-19 (coronavirus disease 2019) pandemic that took over the world in December 2019 has had everlasting devastating impacts on the lives of people globally. It manifests a huge symptom spectrum ranging from asymptomatic to critically ill patients with an unpredictable outcome. Timely diagnosis and assessment of disease severity is imperative for effective treatment. Possibilities exist that by the time symptoms appear the viral load might increase beyond control. However, it is advisable to get adequately diagnosed as soon as the first symptom appears. There is an immediate requirement of reliable biomarkers of COVID-19 manifesting an early onset for effective clinical management, stratification of high risk patients and ensuring ideal resource allocation. In this review, we attempt to explore and describe important polypeptide inflammatory biomarkers, namely C-reactive protein, Procalcitonin, Ferritin, Lactate Dehydrogenase, Serum amyloid A, Interleukin-6, Tumor necrosis factor-alpha and LIGHT used in the detection and management of COVID-19. Viral pathogenesis and the role of these inflammatory biomarkers is highlighted, based on the evidences available till date. An integrative data monitoring along with their correlation with the natural disease progression is of utmost importance in the management of COVID-19. So further research and in-depth analysis of these biomarkers is warranted in the present scenario.

C-Reactive Protein (CRP) Medium and Severe Symptoms Levels of COVID-19

Journal of Drug Delivery and Therapeutics

Coronavirus Disease 2019 (COVID-19) is a disease caused by SARS-CoV-2 and has caused a global pandemic. Patients with COVID-19 can experience symptoms such as fever, dry cough, headache, and shortness of breath which can lead to pneumonia. Excessive inflammation is considered a leading cause of critical illness and death in COVID-19 patients. C-Reactive Protein is a sensitive indicator as an early marker of infection and inflammation. This study presents an overview of the difference in the average CRP levels between patients with moderate and severe confirmed COVID-19 symptoms at UKI Hospital for June-September 2021. The study design was cross-sectional with descriptive and analytical data presentation obtained from medical record documents at UKI Hospital. The average CRP level of COVID-19 patients with moderate symptoms is 63,705 mg/L, totaling 139 patients. The average CRP level of COVID-19 patients with severe symptoms is 132,050 mg/L, totaling 57 patients. The results obtained...