Annexin A1 as a potential prognostic biomarker for COVID-19 disease: case-control study
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CitationCanacik, O., Sabirli, R., Altintas, E., Karsli, E., Karis, D., Kaymaz, B., Tukenmez Sabirli, G., Kurt, Ö., & Koseler, A. (2021). Annexin A1 as a Potential Prognostic Biomarker for COVID-19 Disease: Case-Control Study. International journal of clinical practice, e14606. Advance online publication. https://doi.org/10.1111/ijcp.14606
Background: Annexin A1 (AnxA1) is an important endogenous glucocoticoid protein that contributes to the suppression of inflammation by limiting the production of neutrophil and proinflammatory cytokines.This study aims to determine the clinical predictivity value of blood AnxA1 levels in patients with mild and severe-critical pneumonia induced by COVID-19. Methods: This study employed a prospective, case-control study design and was conducted at Ankara Training and Research hospital between 10.02.2021 and 15.03.2021. A total of 74 patients (42 of whom had moderate and 32 of whom had severe/critical cases of COVID-19 disease according to WHO 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, AnxA1 levels were evaluated using the Enzyme-Linked Immunosorbent Assay(ELISA) method. Results: The serum AnxA1 level was measured as 25.5 (18.6-38.6)ng/mL in the control group, 21.2 (14.7-32) ng/mL in the moderate disease group, and 14.8 (9.7-26.8)ng/mL in the severe/critical disease group. Serum AnxA1 levels were significantly lower in the severe/critical disease group compared to the control and moderate disease groups (p=0.01 and p=0.0001, respectively). Using ROC analysis, a larger area under the curve (AUC) for the serum AnxA1 levels of the control group (AUC=0.715, 95% CI =0.626-0.803;p=0.0001) was calculated compared to the COVID-19 patient group for the diagnosis of COVID-19 disease. The AnxA1 level was found to be 80% sensitive and 54.1% specific at a cut-off level of 18.5 ng/ml for the diagnosis of COVID-19 disease. Moreover, the AnxA1 level was found to be 69.8% sensitive and 58.1% specific at a cut-off level of 17.2 ng/ml in predicting the need for ICU treatment. Conclusion: AnxA1 levels may be a beneficial biomarker in the diagnosis of COVID-19 pneumonia and in predicting the need for ICU treatment in patients with COVID-19 pneumonia at the time of admission to the emergency department (ED).