Köksal DEVECİ, Zeliha Cansel ÖZMEN, Umut ŞAY COŞKUN, Samet ÇAM

Covid-19 hastalarında Hypoxia-Inducible Factor 1α hastalık şiddeti ve prognozunu belirlemede bir biyomarker olabilir mi?

Bu çalışmada akut akciğer hasarı durumlarında bir çok dokuda ve pulmoner dokuda düzeyleri 100 kat artan HIF-1a’nın serum düzeylerinin Covid-19 hastalarında hastalığın şiddeti ve prognozunu takipte etkili bir parametre olarak kullanılıp kullanılamayacağı sorularına yanıt aramak amaçlanmıştır. Çalışmaya Covid-19 klinik şikayetleri ile başvuran 40 hasta ve 20 sağlıklı kontrol bireyi dahil edildi. Hasta grubundan 20 hastanın PCR testi ile Covid-19 tanısı doğrulandı. Diğer 20 hasta ise Covid-19 şüpheli grup olarak kabul edildi. Hasta gruplarının başvuru klinik ve laboratuvar verileri kaydedildi. Covid-19 grubu hastaların başvuru günü ve başvuru sonrası 1. Hafta kan örneklerinden laboratuvar testleri ve serum HIF-1α düzeyleri ölçüldü. Covig-19 grubu hastalık şiddetine göre dört alt gruba ayrılıp her grubun HIF-1α değerleri birbirleri ile karşılaştırıldı. Bu çalışmada covid-19 doğrulanmış hasta grubunda serum HIF-1α değerlerinin sağlıklı kontrol grup serum HIF-1α değerlerinden daha yüksek olduğu bulundu. Bununla birlikte Covid-19 şüpheli grup ile arasında anlamlı farklılık bulunamadı. Covid-19 doğrulanmış hasta grubunda hastane yatış günü serum HIF-1α değerlerinin yatış sonrası HIF-1α değerlerinden yüksek bulunurken, monosit, platelet ve ferritin değerleri ise düşüktü. Covid-19 doğrulanmış hasta grubunun kritik alt grubunun 1. hafta serum HİF-1α değerleri hafif alt grup 0. Gün ve 1. Hafta değerlerinden anlamlı düzeyde düşüktü. Covid-19 grup HIF-1α değerleri hasta yaşı ile güçlü negatif korele bulunurken, platelet sayıları ile zayıf pozitif körele bulundu. COVİD-19 hastalarında alveolar hasarı engellediği düşünülen HIF-1α düzeyleri yükselmektedir. Bununla birlikte HIF-1α düşük seyreden COVİD-19 hastalarında yeterli artış olmaması klinik tablonun ağırlaşmasından sorumlu bir faktör olarak da göz önünde bulundurulabilir.

Anahtar Kelimeler:

Biyobelirteç, Hypoxia-Inducible Factor 1α, SARS-CoV-2

Can Hypoxia-Inducible Factor 1α be used as a biomarker to evaluate disease severity and prognosis in COVID-19 patients?

This study was aimed to answer the questions of whether the serum levels of Hypoxia-Inducible Factor 1α (HIF-1α), which is increased by up to 100 times in many tissues including pulmonary tissue in cases of acute lung injury, could be used as a parameter for monitoring the severity and prognosis in COVID-19 patients. Fourty patients, who were admitted to the hospital with COVID-19 clinical symptoms, and 20 healthy control subjects were included in the study. The diagnosis of 20 patients within the patient group were confirmed by the PCR test. The remaining 20 patients were regarded as COVID-19 suspect group. Clinical and laboratory data of patients on admission were recorded. Clinical laboratory tests and serum HIF-1α levels were measured from the blood samples of COVID-19 group on the day of admission and one week after hospitalization. COVID-19 group was divided into four subgroups according to disease severity and HIF-1α values of each group were compared.In this study, serum HIF-1α values of confirmed COVID-19 patient group were measured higher than healthy control group’s serum HIF-1α values, however no significant difference was found for the COVID-19 suspect group. Within confirmed COVID-19 group, serum HIF-1α values on admission were higher than values after hospitalization, whereas Monocyte count, Platelet count and Ferritin values were lower. Among the confirmed COVID-19 cases, critically ill subgroup’s serum HIF-1α levels of the first week were significantly lower than mild subgroup’s serum HIF-1α levels of both the first week and the day of admission. HIF-1α values of COVID-19 group were strongly negative correlated with age, whereas weakly positive correlated with platelet counts. HIF-1α, which are thought to prevent alveolar damage, increased in COVID-19 patients. Additionally, low levels of HIF-1α in COVID-19 patients might be considered as a factor responsible for the aggravation of the clinical severity.

Keywords:

Biomarker, Hypoxia-Inducible Factor 1α Hypoxia-Inducible Factor 1α, SARS-CoV-2, SARS-CoV-2,

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