Serum interleukin 1β and sP-selectin as biomarkers of inflammation and thrombosis, could they be predictors of disease severity in COVID 19 Egyptian patients? (a cross-sectional study)

Abstract

Background Thromboembolism was a chief cause of mortality in 70% of patients with COVID-19. Our objective was to see if serum interleukins 1 beta (IL-1β) and soluble platelets selectin (sP-selectin) could serve as novel markers of thromboembolism in COVID-19 patients. Methods This cross sectional study involved 89 COVID-19 patients who were recruited from 1st of February to 1st of May 2021. Clinical and laboratory data were collected, and chest imaging was performed. The levels of IL-1β and sP-selectin were assessed in all cases through ELISA kits. Comparisons between groups were done using an unpaired t-test in normally distributed quantitative variables. In contrast, a non-parametric Mann-Whitney test was used for non-normally distributed quantitative variables. Results Severe COVID-19 infection was associated with higher serum levels of CRP, Ferritin, LDH, D dimer, IL-1β and sP-selectin (P < 0.001) with significant correlation between levels of IL-1β and sP-selectin (r 0.37, P < 0.001), D-dimer (r 0.29, P 0.006) and Ferritin (r 0.5, p < 0.001). Likewise, a positive correlation was also found between levels of sP-selectin, D-dimer and Ferritin (r 0.52, P < 0.001) (r 0.59, P < 0.001). Imaging studies revealed that 9 (10.1%) patients developed venous and 14 (15.7%) developed arterial thrombosis despite receiving anticoagulant therapy. Patients with thrombotic events had significantly higher levels of IL-1β, sP-selectin and LDH serum levels. Meanwhile, there was no statistical significance between CRP, D-dimer or Ferritin levels and the development of thrombotic events. Conclusion IL-1β and sP-selectin levels can be promising predictors for severe COVID-19 infection and predictable thrombosis.

Viral uptake and pathophysiology of the lung endothelial cells in age‐associated severe SARS‐CoV‐2 infection models

“…Moreover, it has been previously revealed that the circulating dimerized soluble P‐selectin promotes inflammation and coagulation (Panicker et al., 2017). Additionally, P‐selectin has been reported as one of the biomarkers of COVID‐19 severity (Abd El‐Ghani et al., 2022; Karsli et al., 2021), supporting that our mouse model reflects COVID‐19 pathogenesis. However, our present study has several limitations.…”

Mechanisms of COVID-19 Associated Pulmonary Thrombosis: A Narrative Review

“…IL-1 maintains thrombosis by increasing the time of clot lysis, upregulation of TF expression, and activation of the endothelium via the IL-1β pathway, also promoting the recruitment of leukocytes [ 81 ]. In one study, in patients with COVID-19-associated thrombotic events, no statistical significance was recorded between serum levels of inflammatory markers (CRP, ferritin), age, and other clinical characteristics, except for IL-1β and soluble P-selectin [ 83 ].…”

“…P-selectin, another biomarker of endothelial degranulation, blocks the initial attachment and rolling of platelets and leukocytes to inflammatory regions [ 17 ]. In COVID-19 patients, P-selectin could be a biomarker of severe disease and associated venous thrombosis [ 17 , 83 , 119 , 122 , 123 , 124 ]. P-selectin might also be detrimental in COVID-19 as it promotes NETosis through binding to P-selectin glycoprotein ligand-1 (PSGL-1), leading to the development of immunothrombosis and ALI/ARDS [ 51 , 125 ].…”

“…Cytokines, especially IL-1 and IL-6, and chemokines are involved in all phases of inflammation and thrombosis, using multiple biological pathways [ 18 , 29 , 43 , 44 , 45 , 50 , 51 , 58 , 59 , 60 , 61 , 62 , 66 , 69 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 93 , 94 , 101 , 103 , 129 , 132 , 136 , 137 , 138 ].…”

“…Increased vWF expression, P-selectin, and the disbalance of sTM/nsTM expression in ECs are involved in the development of immunothrombosis, especially in severe COVID-19 [ 4 , 11 , 17 , 51 , 83 , 95 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 121 , 122 , 123 , 124 , 125 , 126 ].…”