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Relationship between serum soluble endothelial protein C receptor level and COVID-19 findings
Nergiz Bayrakci1, Gulsum Ozkan1, Levent Cem Mutlu2
1Department of Nephrology.
Insights
Soluble endothelial protein C receptor (sEPCR) levels are higher in COVID-19 patients, particularly those with positive RT-qPCR tests and specific lung imaging findings. This finding relates sEPCR to COVID-19 severity and inflammation.
Area of Science:
- Coagulation and Thrombosis
- Infectious Diseases
- Medical Imaging
Background:
- COVID-19 is associated with coagulopathy, thrombosis, and inflammation.
- Soluble endothelial protein C receptor (sEPCR) modulates anticoagulant and anti-inflammatory pathways.
Purpose of the Study:
- To investigate the relationship between sEPCR levels and laboratory/imaging findings in COVID-19 patients.
- To compare sEPCR levels between RT-qPCR positive and negative COVID-19 cases.
Main Methods:
- Blood samples were collected from 49 COVID-19 patients (25 RT-qPCR positive, 24 clinically diagnosed).
- Serum sEPCR, hematological, and biochemical parameters were measured.
- Thorax CT scans were performed to assess lung involvement.
Main Results:
- sEPCR levels were significantly higher in RT-qPCR positive patients.
- Higher sEPCR levels correlated with ground-glass opacity and bilateral lung involvement on CT scans.
- No significant difference in symptoms or admission time between RT-qPCR positive and negative groups, except shorter onset-to-admission in positive group.
Conclusions:
- Serum sEPCR levels are elevated in COVID-19 patients with confirmed RT-qPCR results.
- Increased sEPCR is associated with specific lung imaging findings (ground-glass opacity, bilateral involvement) in COVID-19.
- sEPCR may serve as a biomarker for COVID-19 severity and inflammatory status.
Abstract:
Coronavirus-related disease-2019 (COVID-19)-associated coagulopathy presents predominantly with thrombosis and leads to complications in close association with inflammatory process. Soluble endothelial protein C receptor (sEPCR), which is the soluble form of EPCR, reduces the anticoagulant and anti-inflammatory activity of activated protein C. The purpose of this study is to investigate the relationship between sEPCR and the laboratory parameters and thorax computed tomography (CT) findings in the course of COVID-19. Twenty-five laboratory-confirmed [reverse transcription-quantitative polimerase chain reaction (RT-qPCR) positive] and 24 clinically diagnosed (RT-qPCR negative) COVID-19 patients were enrolled in the study. Blood specimens were collected for sEPCR and haematological and biochemical parameter measurement. Thorax CT was performed to detect COVID-19 findings. These parameters from RT-qPCR positive and negative patients were then compared. Although there was no difference between the groups in terms of symptoms, the time between the onset of symptoms and the admission time was shorter in RT-qPCR positive group (P = 0.000). sEPCR levels were significantly higher in the RT-qPCR positive group (P = 0.011). Patients with ground-glass opacity and bilateral involvement on thorax CT have higher serum sEPCR levels (P = 0.012 and 0.043, respectively). This study has shown for the first time that serum sEPCR levels, which is a member of coagulation cascade and has also been reported to be associated with inflammation, is higher in patients with positive RT-qPCR test and patients with GGO or bilateral involvement on thorax CT regardless of the PCR result.
