Elevated Plasma Level of the Glycolysis Byproduct Methylglyoxal on Admission Is an Independent Biomarker of Mortality in ICU COVID-19 Patients

Abstract

Biomarkers to identify ICU COVID-19 patients at high risk for mortality are urgently needed for therapeutic care and management. In this study we found that plasma levels of the glycolysis byproduct methylglyoxal (MG) were 4.4-fold and 1.7-fold higher (P<0.0001) upon ICU admission in patients that later died (n=34) compared to uninfected controls (n=30) and those survived (n=31), respectively. The increase in MG was inversely correlated with glutathione (r2=-0.63) and the MG-glutathione degrading glyoxalase-1 (r2=-0.50), and positively correlated with the inflammation markers, SSAO (r2 =0.52), TNF-a (r2 =0.41), IL-1b (r2 =0.25), CRP (r2 =0.26) and age (r2 =0.20). Logistic regression analysis provides evidence of a significant relationship between the elevated MG upon admission into ICU and death (P<0.0001), with 42% of the death variability explained. From these data we conclude that elevated plasma MG on admission is a novel independent biomarker that predicts ICU COVID-19 patients at high risk of mortality.