Heparin-binding protein levels correlate with aggravation and multiorgan damage in severe COVID-19

Mingshan Xue; Yifeng Zeng; Hui-Qi Qu; Teng Zhang; Ning Li; Huimin Huang; Peiyan Zheng; Haisheng Hu; Luqian Zhou; Zhifeng Duan; Yong Zhang; Wei Bao; Li-Feng Tian; Hakon Hakonarson; Nanshan Zhong; Xiaohua Douglas Zhang; Baoqing Sun

doi:10.1183/23120541.00741-2020

Heparin-binding protein levels correlate with aggravation and multiorgan damage in severe COVID-19

ERJ Open Res. 2021 Feb 1;7(1):00741-2020. doi: 10.1183/23120541.00741-2020. eCollection 2021 Jan.

Authors

Mingshan Xue^{1

2}, Yifeng Zeng^{1

2}, Hui-Qi Qu^{3

2}, Teng Zhang⁴, Ning Li¹, Huimin Huang¹, Peiyan Zheng¹, Haisheng Hu¹, Luqian Zhou¹, Zhifeng Duan³, Yong Zhang³, Wei Bao³, Li-Feng Tian³, Hakon Hakonarson^{3

5}, Nanshan Zhong¹, Xiaohua Douglas Zhang⁴, Baoqing Sun¹

Affiliations

¹ State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² These authors contributed equally.
³ Arctic Therapeutics at University of Akureyri, Borgir, Akureyri, Iceland.
⁴ Faculty of Health Sciences, University of Macau, Taipa, Macau, China.
⁵ Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Abstract

Background: Critically ill coronavirus disease 2019 (COVID-19) patients may suffer persistent systemic inflammation and multiple organ failure, leading to a poor prognosis.

Research question: To examine the relevance of the novel inflammatory factor heparin-binding protein (HBP) in critically ill COVID-19 patients, and evaluate the correlation of the biomarker with disease progression.

Study design and methods: 18 critically ill COVID-19 patients who suffered from respiratory failure and sepsis, including 12 cases who experienced a rapidly deteriorating clinical condition and six cases without deterioration, were investigated. They were compared with 15 age- and sex- matched COVID-19-negative patients with respiratory failure. Clinical data were collected and HBP levels were investigated.

Results: HBP was significantly increased in critically ill COVID-19 patients following disease aggravation and tracked with disease progression. HBP elevation preceded the clinical manifestations for up to 5 days and was closely correlated with patients' pulmonary ventilation and perfusion status.

Interpretation: HBP levels are associated with COVID-19 disease progression in critically ill patients. As a potential mediator of disease aggravation and multiple organ injuries that are triggered by continuing inflammation and oxygen deficits, HBP warrants further study as a disease biomarker and potential therapeutic target.