مستويات الكالبروتكتين والسيستاتين سي في مرضى كوفيد -19 الحاد والمتوسط وعلاقاتهم بجزيء إصابة الكلى -1

Calprotectin and Cystatin C Levels in Severe and Moderate Covid-19 Patients and their Correlations with Kidney Injury Molecule-1

Abstract

Background: Coronavirus disease (Covid-19) causes severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) was spread to hundreds of countries and it is served as global pandemic. Death occurs as a result of severe Covid-19 due to increasing hypoxemia, acute respiratory distress syndrome (ARDS), and multi-organ failure. Covid-19 affects the kidneys in approximately 3-9% of patients and its developed acute kidney damage (AKI) and it is significantly higher.
Calprotectin is a member of the calcium-binding S100 protein family and it is a heterodimeric protein, found in the cytoplasm of neutrophils and monocytes, both of which play important roles in the inflammatory response in the human body. Calprotectin used an early biomarker in coronavirus disease with bacterial co-infections and patients at risk to develop severe events. Kidney injury molecule 1 (KIM-1) is a transmembrane glycoprotein that is up-regulated in the proximal tubule after kidney injury.
The aim of this study for evaluating severity in cases of Covid- 19 patients by measuring Calprotectin and Cystatin C levels and study the correlation with Kidney injury molecule-1 and others biomarkers.
Material and Methods: The study was a cross sectional study. This study included 91 samples patients with Covid-19 include (56 male, 35 female) ranged between (22-88)years patients. The study was conducted from Al-hayat unit, Al-Hussein Teaching Hospital, Al-Hussein Medical City during the period from (Oct., 2020 to July., 2021). COVID-19 cases were divided into three groups based on disease severity (moderate and severe). The levels of bio-markers were measured for following parameter Ferritin, C-reactive protein total lactate dehydrogenase activity, creatinine, urea, (cystatin C, calprotectin, and kidney injury molecule-1) by ELISA and complete blood count test by XP-300™ Automated hematology analyzer Sysmex.
Results: According to the presented results which include 46 case of severe group and 45 case of moderate group of Covid-19 patients, there is positive correlation between Kidney injury molecule-1 and Cystatin C in severe(p< 0.01) and moderate group (p>0.05) and with Calprotectin (p<0.01) in severe group. There was positive correlation between Cystatin C and S.Creatinine in severe group. There is no significant correlation when compared (Calprotectin Cystatin C and kidney injury molecule-1) among moderate and severe group (p <0.05)
Conclusion: The obtained results illustrated that was positive correlation between Kidney Kidney injury molecule-1, Cystatin C and Calprotectin. And positive correlation between Cystatin C and S.Creatinine in severe group. There is no significant correlation in Calprotecti, Cystatin C and Kidney injury molecule-1 among moderate and severe cases of Covid-19.