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Diagnostic Usefulness of Serum Hyaluronic Acid in Patients with SARS-CoV-2 Infection
Bogdan Cylwik1, Kacper Gan2, Marcin Kazberuk2
1Department of Paediatric Laboratory Diagnostics, Medical University of Bialystok, 15-274 Bialystok, Poland.
Insights
Serum hyaluronic acid (HA) is significantly elevated in COVID-19 patients, correlating with disease severity and mortality risk. This finding suggests HA could serve as a novel biomarker for predicting severe SARS-CoV-2 infection outcomes.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Background:
- COVID-19, caused by SARS-CoV-2, presents a wide spectrum of disease severity.
- Identifying reliable biomarkers for disease progression and mortality is crucial for patient management.
- Serum hyaluronic acid (HA) is a component of the extracellular matrix with potential roles in inflammation and tissue repair.
Purpose of the Study:
- To evaluate the diagnostic utility of serum hyaluronic acid (HA) levels in patients with COVID-19.
- To determine the association between serum HA concentrations and COVID-19 disease severity, treatment requirements, and mortality.
Main Methods:
- Serum HA concentrations were measured using an immunochemical method.
- The study included 87 COVID-19 patients and 45 healthy controls.
- Statistical analyses compared HA levels across different disease severity groups, treatment modalities, and survival outcomes.
Main Results:
- COVID-19 patients exhibited significantly higher serum HA levels compared to healthy controls.
- Elevated HA concentrations were observed in patients with critical disease severity, those requiring mechanical ventilation, and those receiving steroid treatment or immunotherapy.
- Serum HA levels were significantly higher in patients with cytokine storm and in non-survivors compared to survivors, demonstrating excellent diagnostic power for predicting critical illness and mortality.
Conclusions:
- Serum hyaluronic acid (HA) is strongly associated with severe SARS-CoV-2 infection.
- HA demonstrates potential as a novel serum biomarker for predicting disease progression and mortality in COVID-19 patients.
- Further research may validate HA's role in clinical decision-making for COVID-19 management.
Abstract:
Background/Objective: The aim of our study is to comprehensively assess the diagnostic usefulness of serum hyaluronic acid (HA) determination in COVID-19 patients. Methods: The study group included 87 patients with COVID-19 disease and 45 healthy subjects. The HA concentration was measured using the immunochemical method. Results: The serum HA concentration was significantly higher in the COVID-19 patients before admission to hospital than that in the controls (p < 0.001). Differences were found in HA levels between the groups categorized according to disease severity (p = 002), being significantly higher in patients with critical as compared to moderate disease severity (p < 0.001). The HA concentration varied depending on the type of oxygen therapy (p = 0.004). It was significantly higher in patients on a ventilator than in those without oxygen therapy (p = 0.002). In patients who qualified for the steroid treatment and immunotherapy, the HA levels were significantly higher compared to those who did not qualify for such therapies (p = 0.043, p = 0.049, respectively). The HA levels were significantly higher in patients with cytokine storm compared to those without it (p < 0.001) and were significantly more elevated in non-survivors than in survivors (p < 0.001). HA had an excellent diagnostic power (AUC = 0.994) with sensitivity (83.3%) and specificity (97.8%) in identifying patients with critical disease severity and an excellent diagnostic power (AUC = 0.932) with sensitivity (88.2%) and specificity (95.6%) in identifying non-surviving patients. Conclusions: In summary, the results of our study indicate that HA is closely associated with severe SARS-CoV-2 infection and could be used as a novel serum biomarker to predict the risk of disease progression and as a predictor of COVID-19 mortality.
