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Low level of plasminogen increases risk for mortality in COVID-19 patients

David Della-Morte1,2,3,4, Francesca Pacifici5, Camillo Ricordi6

  • 1Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. david.dellamorte@uniroma2.it.

Cell Death & Disease
|August 6, 2021
PubMed

Insights

Low plasminogen levels are linked to severe COVID-19 complications and mortality. This finding suggests plasminogen may serve as a crucial prognostic biomarker and potential therapeutic target for coronavirus disease 2019.

Area of Science:

  • * Internal Medicine
  • * Pathophysiology
  • * Biochemistry

Background:

  • * Coronavirus disease 2019 (COVID-19) pathophysiology and thromboembolic complications remain incompletely understood.
  • * Thromboembolic events are a major cause of mortality in COVID-19 patients.
  • * Plasminogen, a precursor to fibrinolysis, has been hypothesized to play a role in COVID-19 complications.

Purpose of the Study:

  • * To investigate the association between plasminogen levels and COVID-19-related outcomes.
  • * To explore plasminogen's potential as a prognostic biomarker and therapeutic target in COVID-19.

Main Methods:

  • * Analysis of plasminogen levels in 55 Caucasian COVID-19 patients.
  • * Correlation of plasminogen levels with inflammatory markers (CRP, PCT, IL-6), coagulation markers (D-dimer, INR, APTT), and organ dysfunction markers.
  • * Multidimensional analysis to assess the relationship between coagulation, inflammation, and plasminogen.

Main Results:

  • * Low plasminogen levels significantly correlated with heightened inflammation, coagulation activation, and organ dysfunction.
  • * Plasminogen clustering with IL-6 suggests a shared activation pathway in disease complications.
  • * Low plasminogen levels strongly predicted mortality in COVID-19 patients, even after adjusting for confounders.

Conclusions:

  • * Plasminogen plays a critical role in managing the complex mechanisms underlying COVID-19 complications.
  • * Plasminogen levels can serve as a valuable prognostic biomarker for COVID-19 patients.
  • * Targeting plasminogen may offer a therapeutic strategy against severe COVID-19.

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