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Same virus, different course: The relationship between monocyte chemoattractant protein-1 and surfactant protein-A levels and clinical course and prognosis of COVID-19
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  • Ferhan Kerget,
  • Buğra Kerget,
  • Sibel İba Yılmaz,
  • Ömer Karaşahin,
  • Ahmet Kızıltunç,
  • Mehtap Hülya Aslan
Ferhan Kerget

Corresponding Author:drferhan68@hotmail.com

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Buğra Kerget
Ataturk Universitesi
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Sibel İba Yılmaz
Erzurum Bolge Egitim ve Arastirma Hastanesi
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Ömer Karaşahin
Erzurum Bolge Egitim ve Arastirma Hastanesi
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Ahmet Kızıltunç
Ataturk Universitesi
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Mehtap Hülya Aslan
Erzurum Bolge Egitim ve Arastirma Hastanesi
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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.