Same virus, different course: The relationship between monocyte
chemoattractant protein-1 and surfactant protein-A levels and clinical
course and prognosis of COVID-19
Abstract
Objective: To date, over 7 million people have been infected in the
COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 which
emerged in Wuhan, China in December 2019. This study examined the
relationships between serum monocyte chemoattractant protein-1 (MCP-1)
and surfactant protein-A (SP-A) levels and the clinical course and
prognosis of COVID-19. Method: The study included a total of 108
subjects. Those in the patient group (n=88) were diagnosed with COVID-19
using real-time PCR analysis of nasopharyngeal swab samples and treated
in the Atatürk University Pulmonary Diseases and the City Hospital
Infectious Diseases department between March 24 and April 15. The
control group (n=20) included asymptomatic healthcare workers whose
real-time PCR results during routine COVID-19 screening in our hospital
were negative. Results: The COVID-19 patient group had significantly
higher MCP-1 and SP-A levels compared to the control group (p=0.001,
p=0.001). Patients who developed macrophage activation syndrome had
significantly higher MCP-1 and SP-A levels than those who did not both
at admission (p=0.001, p=0.001) and on day 5 of treatment (p=0.05,
p=0.04). Similarly, MCP-1 and SP-A levels were significantly higher in
patients who developed acute respiratory distress syndrome compared to
those who did not at both time points (p=0.001 for all). Both parameters
were significantly higher in nonsurviving COVID-19 patients compared to
survivors (p=0.001 for both). Conclusion: MCP-1 and SP-A are on opposing
sides of the inflammatory balance, and SP-A may be a pneumoprotein of
importance in the presentation, course, prognosis, and possibly the
treatment of COVID-19 in the future.