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Association of complement pathways with COVID-19 severity and outcomes
Kishor Devalaraja-Narashimha1, Peter J Ehmann1, Cong Huang2
1Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
Microbes and Infection
|December 9, 2022
Summary
Complement activation is key in COVID-19. High levels of certain complement biomarkers indicate increased mortality risk in hospitalized patients, suggesting their use as prognostic indicators.
Area of Science:
- Immunology
- Pathophysiology
- Biomarker Discovery
Background:
- Complement activation is implicated in the pathogenesis of COVID-19.
- Understanding complement's role is crucial for managing severe disease.
Purpose of the Study:
- To assess complement activation products and protein levels in hospitalized COVID-19 patients.
- To evaluate complement pathway markers as predictors of clinical outcomes.
Main Methods:
- Longitudinal measurements of complement biomarkers in 89 hospitalized COVID-19 patients.
- Correlation of biomarker levels with clinical and laboratory parameters in a randomized trial setting.
Main Results:
- All complement pathways were activated; alternative pathway activation was predominant early in disease.
- Complement biomarkers correlated with multi-organ dysfunction and inflammatory injury.
- Elevated sC5b-9, C3a, factor Bb, and low mannan-binding lectin levels were associated with increased mortality.
Conclusions:
- Specific complement pathway components are important prognostic biomarkers in COVID-19.
- These findings enhance understanding of COVID-19 pathophysiology.