Galectin-3 as a Potential Prognostic Biomarker for COVID-19 Disease: A Case-Control Study

Abstract

BackgroundRecent studies have investigated the importance of Galetin-3 in inflammation, fibrosis, cell proliferation, cardiac disease, diabetes, and tumor formation. AimsThis study aims to investigate the role of the Galectin-3 level in the diagnosis of COVID-19 pneumonia and the value of the Galectin-3 level in predicting the clinical course of the patient. MethodsThis study employed a prospective, case-control study design and was conducted at Bakircay University Ciğli Training and Research Hospital. A total of 100 patients (40 had moderate and 60 had severe/critical COVID-19 disease according to World Health Organisation guidelines) and 50 non-symptomatic healthy volunteers participated in the study. Blood samples were taken from patients at the time of hospital admission, after which serum was isolated. Following the isolation of serum, Galectin-3 levels were evaluated using the enzyme-linked immunosorbent assay (ELISA) method. ResultsThe serum Galectin-3 level was measured as 13.57 (10.9-16.4) ng/mL in the control group, 13.52 (10.69-16.6) ng/mL in the moderate disease group, and 11.65 (6.09-14.33) ng/mL in the severe/critical disease group. Serum Galectin-3 levels were significantly lower in the severe/critical disease group compared to the control and moderate disease groups (p=0.001 and p=0.019, respectively).Using ROC analysis, a larger area under the curve (AUC) for the serum Galectin-3 levels of the control group (AUC=0.622, 95% CI =0.529-0.714; p=0.015) was calculated compared to the COVID-19 patient group for the diagnosis of COVID-19 disease. The Galectin-3 level was found to be 75% sensitive and 50% specific at a cutoff level of 11.3 ng/mL in predicting the need for ICU treatment. ConclusionGalectin-3 levels may be a beneficial biomarker in predicting the clinical severity of COVID-19 disease when used in conjunction with other known biomarkers, at the time of admission to the emergency department (ED).

Galectins can serve as biomarkers in COVID-19: A comprehensive systematic review and meta-analysis

“…The outliers for this analysis were recognized using the Galbraith plot, which is shown in Supplementary Figure 1. After removing Karsli et al (33), no change was observed in the significance of the results (SMD 0.69, 95% CI 0.44 to 0.94, P < 0.01, Figure 3), although heterogeneity was reduced to 60.42%. Removing five of the studies made the overall result insignificant (21,22,27,31,32).…”

“…In line with this, Kusnierz-Cabala et al (34) reported no significant difference in serum Gal-3 levels in COVID-19 patients compared with healthy controls. Meanwhile, Karsli et al (33) reported that Gal-3 levels are lower in severe COVID-19 patients than in healthy controls.…”

“…The Galbraith plot did not reveal any outlier study for this analysis (Supplementary Figure 6). However, in sensitivity analysis, removing Karsli et al made the overall result significant (33).…”

“…After removing duplicates, 524 records were screened by titles and abstracts. Following this step, 63 studies were evaluated by full texts, resulting in 18 final included studies (7,(19)(20)(21)(22)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow chart summarizing the selection process is available in Figure 1.…”

“…In a study by Kusnierz-Cabala et al (34), the Gal-3 level was significantly higher in patients needing ICU treatment than those without it (4.77 [2.92-8.17] ng/ml vs. 2.30 [1.88-3.21] ng/ml, P = 0.001). Bruni et al ( 29) study defined a composite endpoint of admission to ICU or 30-day mortality and Forest plot for the meta-analysis of Gal-3 levels in COVID-19 patients vs. healthy controls after removing the outlier study (33). Forest plot for the meta-analysis of Gal-3 levels in severe vs. non-severe COVID-19.…”