علاقة مستقبلات كيموكين المصلية 1 ومستقبلات كيموكين 5 مع شدة مرض كورونا( مرض كوفيد -19)

Association of serum chemokine receptor 1and chemokine receptor 5 with COVID-19 severity

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), is now pandemic with nearly 219 million cases reported to date. Although the majority of COVID-19 patients experience only mild or moderate symptoms, a subset will progress to severe disease with pneumonia and acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Emerging results indicate a dysregulated immune response characterized by runaway inflammation, including cytokine release syndrome (CRS). Critically ill COVID-19 patients experiencing chemokine storm are believed to have a worse prognosis and increased fatality rate.
In SARS-CoV-2 infected patients, chemokine storm appears important to the pathogenesis of several severe manifestations of COVID-19 as acute respiratory distress syndrome. The chemokine receptor seems to be a key player since it is involved in the development and progression of the most dangerous and potentially life-threatening COVID-19. Understanding the pathogenesis of chemokine storm will help unravel not only risk factors for the condition but also therapeutic strategies to modulate the immune response and deliver improved outcomes in COVID-19 patients at high risk for severe disease. So, the aim of the current study is to reveal the relation between chemokine receptors (CCR1, CCR5) and severity of COVID-19 disease with its role in pathogenesis and future possible treatment. Ninety blood samples were taken from patients who were according clinical examine ,PCR result and CT scan diagnosed with coronavirus. Samples were taken from both sexes (50) males and (40) females, their ages ranged between (20-85) and were divided into moderate and sever-critical cases. All included patients were from the Internal Medicine Department and the Intensive Care Unit of Al-Husseini Teaching Hospital in Karbala / Iraq during the period from December 2020 until February 2021. Analysis of blood samples was done using ELISA kits for chemokine receptors CCR1 and CCR5. The mean CCR1 & CCR-5 levels were significantly lower in patients with severe-critical cases than those with moderate COVID-19 with P<0.001.
Receiver Operating Characteristics (ROC) curve analysis was performed and revealed that CCR1 & CCR-5 were good predictor of severe form of disease with the area under the ROC curve (AUC) = 0.937, 0.852 respectively with high sensitivity and specificity. This study shown that lower serum level of CCR1 and CCR5 associated with more severe disease status and both receptors could be regarded as good biomarkers for severity in COVID-19 infection.