Could Eosinophil Cationic Protein Be A Useful Biomarker In The Diagnosis Of Covid-19?

Year 2021, Volume: 11 Issue: 2, 328 - 336, 29.06.2021

Muzaffer Katar , Murat Beyhan , Osman Demir

https://doi.org/10.31832/smj.821617

Abstract

Objective
Covid-19 disease is diagnosed by moleculer, serologic or radiological methods. However, these diagnostic methods cannot be reached everywhere or take too much time to result. So, we need for effective diagnosis of Covid-19 patients with simple and easy accessible laboratory biomarkers. Therefore, we investigated the diagnostic performance of Eosinophilic Cationic Protein (ECP) in Covid-19.
Material and Methods
Our study is a retrospective case-control study. The recorded clinical, laboratory and radiological data of 30 patients who were diagnosed with Covid-19, between 15 March and 15 June 2020, were compared with 30 healthy person by using appropriate statistical methods.
Results
Both patients and conrols included 10 (33.3%) females and 20 (66.6%) males with a mean age of 57.2 ± 15.46 and 60.07 ± 20.59 respectively. Eosinophil counts of the patients at admission were significantly lower than the controls (p <0.001). Eosinophil counts one week after admission were increased significantly compared to the admission levels (p= 0.004). ECP values of the patients one week after admission were significantly lower than controls and decreased compared to the admission (p= 0.023, p= 0.001respectively). ECP values of one week later, differentiated patients and controls with 46.7% sensitivity, 93.3% specificity and a cutoff value of ≤ 88.67 ng/mL. ROC analysis of ECP2; (AUC)= O.740, p= 0.023.
Conclusion
It will be of great benefit in terms of public health that suspected patients of Covid-19 are quickly isolated from other patients with similar symptoms, with a simple ECP test and started taking empirical treatment.

Keywords

Covid-19, Diagnosis, ECP, Eosinopenia, Lymphopenia, Neutropenia

Eozinofil Katyonik Protein, Covid-19 Tanısında Kullanışlı Bir Biyobelirteç Olabilir Mi?

Abstract

Amaç
Covid-19 hastalığı, moleküler, serolojik veya radyolojik yöntemlerle teşhis edilir. Bununla birlikte, bu teşhis yöntemlerine her yerde ulaşılamaz veya sonuçlanması çok fazla zaman alabilir. Bu nedenle, Covid-19 hastalarının basit ve kolay erişilebilir laboratuvar biyobelirteçleri ile etkili teşhisine ihtiyacımız var. Bu nedenle Covid-19'da Eozinofilik Katyonik Proteinin (ECP) tanısal performansını araştırdık.
Gereç ve yöntemler
Çalışmamız geriye dönük bir vaka-kontrol çalışmasıdır. 15 Mart - 15 Haziran 2020 tarihleri arasında Covid-19 teşhisi konulan 30 hastanın kaydedilen klinik, laboratuvar ve radyolojik verileri uygun istatistiksel yöntemler kullanılarak 30 sağlıklı kişi ile karşılaştırıldı.
Sonuçlar
Hastalar ve kontroller sırasıyla ortalama yaşları 57,2 ± 15,46 ve 60,07 ± 20,59 olan 10 (% 33,3) kadın ve 20 (% 66,6) erkeklerdi. Hastaların başvuru sırasındaki eozinofil sayıları kontrollere göre anlamlı olarak düşüktü (p <0.001). Yatıştan bir hafta sonra eozinofil sayıları başvuru düzeylerine göre anlamlı olarak arttı (p = 0,004). Hastaların yatışından bir hafta sonra ECP değerleri kontrollere göre anlamlı olarak düşüktü ve yatışa göre azalmıştı (sırasıyla p = 0,023, p = 0,001). Bir hafta sonraki ECP değerleri,% 46,7 duyarlılık,% 93,3 özgüllük ve ≤ 88,67 ng / mL kesme değeri ile hasta ve kontrolleri farklılaştırmıştır. ECP2'nin ROC analizi; (AUC) = 0,740, p = 0,023.
Sonuç
Covid-19 şüpheli hastaların benzer semptomları olan diğer hastalardan basit bir ECP testi ile hızlı bir şekilde izole edilmesi ve ampirik tedaviye başlanması halk sağlığı açısından büyük fayda sağlayacaktır.

Keywords

Covid-19, Tanı, ECP, Eozinopeni, Lenfopeni, Nötropeni

References

• 1. Rothenberg ME, Hogan SP. The eosinophil. Annual review of immunology. 2006;24.
• 2. Burris D, Rosenberg CE, Schwartz JT, Zhang Y, Eby MD, Abonia JP, et al. Pediatric hypereosinophilia: characteristics, clinical manifestations, and diagnoses. The Journal of Allergy and Clinical Immunology: In Practice. 2019;7(8):2750-8. e2.
• 3. Weller PF, Spencer LA. Functions of tissue-resident eosinophils. Nature Reviews Immunology. 2017;17(12):746-60.
• 4. Peona V, Amici MD, Quaglini S, Bellaviti G, Castellazzi AM, Marseglia G, et al. Serum eosinophilic cationic protein: is there a role in respiratory disorders? Journal of Asthma. 2010;47(2):131-4.
• 5. Karawajczyk M, Pauksen K, Peterson C, Eklund E, Venge P. The differential release of eosinophil granule proteins. Studies on patients with acute bacterial and viral infections. Clinical & Experimental Allergy. 1995;25(8):713-9.
• 6. Dodig S. Eosinophil catonic protein–current concepts and controversies. Biochemia medica. 2011;21(2):111-21.
• 7. Flores-Torres AS, Salinas-Carmona MC, Salinas E, Rosas-Taraco AG. Eosinophils and respiratory viruses. Viral Immunology. 2019;32(5):198-207.
• 8. Li Y, Wu W, Yang T, Zhou W, Fu Y, Feng Q, et al. Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19. Zhonghua nei ke za zhi. 2020;59:E003-E.
• 9. Riggioni C, Comberiati P, Giovannini M, Agache I, Akdis M, Alves-Correia M, et al. A compendium answering 150 questions on COVID-19 and SARS-CoV-2. Allergy. 2020:10-111.
• 10. Venge P, Byström J. Molecules in focus eosinophil cationic protein (ECP). The international journal of biochemistry & cell biology. 1998;30(4):433-7.
• 11. Akuthota P, Wang H, Spencer L, Weller P. Immunoregulatory roles of eosinophils: a new look at a familiar cell. Clinical & Experimental Allergy. 2008;38(8):1254-63.
• 12. Zagai U, Sköld C, Trulson A, Venge P, Lundahl J. The effect of eosinophils on collagen gel contraction and implications for tissue remodelling. Clinical & Experimental Immunology. 2004;135(3):427-33.
• 13. Gleich GJ. Mechanisms of eosinophil-associated inflammation. Journal of Allergy and Clinical Immunology. 2000;105(4):651-63.
• 14. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet Infectious Diseases. 2020.
• 15. Hamann KJ, Ten RM, Loegering DA, Jenkins RB, Heise MT, Schad CR, et al. Structure and chromosome localization of the human eosinophil-derived neurotoxin and eosinophil cationic protein genes: evidence for intronless coding sequences in the ribonuclease gene superfamily. Genomics. 1990;7(4):535-46.
• 16. Young JD, Peterson CG, Venge P, Cohn ZA. Mechanism of membrane damage mediated by human eosinophil cationic protein. Nature. 1986;321(6070):613-6.
• 17. Venge P, Byström J, Carlson M, Hakansson L, Karawacjzyk M. Eosinophil cationic protein (ECP): molecular and biological properties and the use of ECP as a marker of eosinophil activation in disease. Clinical and experimental allergy (Print). 1999;29(9):1172-86.
• 18. Suzuki K, Kato M, Matsuda S, Nukaga M, Enseki M, Tabata H, et al. IP-10 is elevated in virus-induced acute exacerbations in childhood asthma. Tokai J Exp Clin Med. 2016;41(4):210-7.
• 19. Zimmerman B, Enander I, Zimmerman R, Ahlstedt S. Asthma in children less than 5 years of age: eosinophils and serum levels of the eosinophil proteins ECP and EPX in relation to atopy and symptoms. Clinical & Experimental Allergy. 1994;24(2):149-55.
• 20. Paganelli R, Fanales-Belasio E, Scala E, Carmini D, Mezzaroma I, Pinter E, et al. Serum eosinophil cationic protein (ECP) in human immunodeficiency virus (HIV) infection. Journal of allergy and clinical immunology. 1991;88(3):416-8.
• 21. Venge P, Strömberg A, Braconier J, Roxin LE, Olsson I. Neutrophil and eosinophil granulocytes in bacterial infection: sequential studies of cellular and serum levels of granule proteins. British journal of haematology. 1978;38(4):475-83.