Evaluation of urinary cysteinyl leukotrienes as biomarkers of severity and putative therapeutic targets in COVID-19 patients

Data de publicação: 01/03/2023 Data Ahead of Print: 01/01/2023

Autores da FMUP

• Marta Fernanda Reina Couto

  Autor

• Dora Raquel Da Silva Pinho

  Autor

• Claudia Camila Rodrigues Pereira Dias

  Autor

• António Carlos Megre Eugénio Sarmento

  Autor

• João Tiago De Sousa Pinto Guimarães

  Autor

• Roberto Liberal Fernandes Roncon Albuquerque

  Autor

• José Artur Osório De Carvalho Paiva

  Autor

• Teresa Maria De Jesus Teixeira De Sousa

  Autor

Participantes de fora da FMUP

• Roboredo-Madeira, M
• Pereira-Terra, P
• Silva-Pereira, C
• Martins, S
• Teixeira-Santos, L
• Dias, A
• Cordeiro, G
• Tavares, M
• Albino-Teixeira, A

Unidades de investigação

• Biomedicina

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• Recursos Comuns

  

  Investigador

  Guilhermina Maria Da Silva Rêgo

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background Cysteinyl leukotrienes (CysLT) are potent inflammation-promoting mediators, but remain scarcely explored in COVID-19. We evaluated urinary CysLT (U-CysLT) relationship with disease severity and their usefulness for prognostication in hospitalized COVID-19 patients. The impact on U-CysLT of veno-venous extracorporeal membrane oxygenation (VV-ECMO) and of comorbidities such as hypertension and obesity was also assessed. Methods Blood and spot urine were collected in "severe " (n = 26), "critically ill " (n = 17) and "critically ill on VV-ECMO " (n = 17) patients with COVID-19 at days 1-2 (admission), 3-4, 5-8 and weekly thereafter, and in controls (n = 23) at a single time point. U-CysLT were measured by ELISA. Routine markers, prognostic scores and outcomes were also evaluated. Results U-CysLT did not differ between groups at admission, but significantly increased along hospitalization only in critical groups, being markedly higher in VV-ECMO patients, especially in hypertensives. U-CysLT values during the first week were positively associated with ICU and total hospital length of stay in critical groups and showed acceptable area under curve (AUC) for prediction of 30-day mortality (AUC: 0.734, p = 0.001) among all patients. Conclusions U-CysLT increase during hospitalization in critical COVID-19 patients, especially in hypertensives on VV-ECMO. U-CysLT association with severe outcomes suggests their usefulness for prognostication and as therapeutic targets.

Keywords

• Urinary cysteinyl leukotrienes; COVID-19; Disease severity; Veno-venous extracorporeal membrane oxygenation (VV-ECMO); Outcomes; Comorbidities