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Surfactant protein levels and genetic variants as biomarkers for COVID-19 severity in children

Natalie Sicher1, Brycen Aldrich1, Shaoyi Zhang2

  • 1Department of Pediatrics, The Pennsylvania State College of Medicine, Hershey, Pennsylvania, United States.

American Journal of Physiology. Lung Cellular and Molecular Physiology
|January 20, 2025
PubMed

Insights

Elevated surfactant protein A (SP-A) levels in children with COVID-19 are linked to severe disease. A threshold of 10 ng/mL for SP-A may predict severe outcomes, suggesting its potential as a biomarker.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Biomarker Discovery

Background:

  • COVID-19 significantly impacts children, with pulmonary surfactant dysfunction implicated in other respiratory illnesses.
  • The precise role of surfactant proteins (SPs) in pediatric COVID-19 severity is not well-established.
  • Surfactant dysfunction is a known factor in various pediatric respiratory conditions.

Purpose of the Study:

  • To investigate the association between surfactant protein levels and single nucleotide polymorphisms (SNPs) in SP genes with COVID-19 severity in children.
  • To identify potential biomarkers for predicting severe COVID-19 outcomes in pediatric patients.
  • To explore the relationship between SP gene variants and the risk of severe disease.

Main Methods:

  • Plasma levels of surfactant protein A (SP-A), SP-B, and SP-D were measured in 325 pediatric COVID-19 patients.
  • Genotyping was performed for SNPs in five SP genes: SFTPA1, SFTPA2, SFTPB, SFTPC, and SFTPD.
  • Statistical analyses, including quantile regression and logistic regression, were used to assess associations between SP levels, SNPs, and disease severity.

Main Results:

  • Increased plasma SP-A levels were significantly associated with severe COVID-19 in children.
  • A plasma SP-A level of 10 ng/mL was identified as an optimal cutoff for predicting severe disease (Odds Ratio = 5.9).
  • No significant association was found between SP-B or SP-D levels and COVID-19 severity. The SFTPC SNP rs8192340 showed a trend towards decreased severe risk before correction.

Conclusions:

  • Plasma SP-A may serve as a valuable predictive biomarker for severe COVID-19 in the pediatric population.
  • Elevated SP-A levels are linked to increased likelihood of severe COVID-19 in children.
  • Further research into SP gene variants may offer insights into disease risk stratification.

Keywords:
COVID-19surfactant protein genetic variantssurfactant protein-A

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