Circulating mortalin in blood and activation of the alternative complement pathway as risk indicators in COVID-19 infection

• DOI: 10.3389/fimmu.2024.1337215
• Publication Date: 2024-04-23T04:27:53Z
• Authors: Maya Avraham; György Sinkovits; Lisa Hurler; Zoltán Prohászka; Zvi Fishelson
• Keywords: mortalin; Male; Adult; Aged, 80 and over; 0303 health sciences; SARS-CoV-2; overall survival; Immunology; COVID-19; RC581-607; Middle Aged; Prognosis; Severity of Illness Index; 03 medical and health sciences; risk factor; Grp75; Humans; complement; HSP70 Heat-Shock Proteins; Female; Immunologic diseases. Allergy; Complement Activation; Biomarkers; Aged

Background Mortalin/GRP75 is a ubiquitous mitochondrial chaperone related to the cytosolic heat shock protein 70. It protects cells from various types of damages and senescence. Our goal was determine whether COVID-19 patients have circulating mortalin in their blood assess its prognostic value anticipating disease severity. Methods Mortalin determined by ELISA sera 83 enrolled study. Patients were categorized into 4 groups: critical who died (FATAL) or required intensive care survived (ICU), mild severity (hospitalized but not critical) nasal oxygen support (HOSP+O 2 ), did need therapy (HOSP). Results The concentration serum all cohort 194-2324 pg/mL. A comparison levels peak among patient groups showed highly significant difference between HOSP FATAL ICU groups. eventually failed survive had at hospitalization markedly higher level sera. Cox regression analysis revealed high mortality hazard (HR=3.96, p<0.01) with (above median, ≥651 pg/mL). This confirmed survival curve (Kaplan-Meier; p=0.0032, log-rank test). remained an independent predictor even after adjusting for age sex complement activation products. Complement data collected earlier study same compared regarding levels. also C3a reduced properdin. Discussion first report on patients. Higher associated more severe illnesses risk death. We claim that quantifying activated proteins will provide important information prognosis serve as useful tool guiding clinical management treatment.