Neopterin is released by macrophages during inflammatory responses leading to cytokine storms, a hall-mark of SARS-CoV-2 infection. Hence, a case-control design study was conducted to analyze the association of serum neopterin levels with COVID-19. A total of 610 individuals participated of which 374 were hospitalized COVID-19 patients and 256 were healthy donors. Hospitalized COVID-19 patients were all symptomatic and displayed a large spectrum of comorbidities.
The patients were followed until disease resolution or death. Upon comparing the serum neopterin levels of COVID-19 patients with the healthy individuals it was found that COVID-19 patients had significantly elevated neopterin levels.
The concentration of neopterin in COVID-19 patients at admission was 56 nM whereas the neopterin concentration in healthy individuals was the only 9.5nM. Moreover, systemic neopterin levels above 53nM distinguished between non-survivors and survivors with 64% specificity and 100% sensitivity. Furthermore, it was also assessed that neopterin levels were not associated with variables such as country, hypertension, and in particular age which can appear to be risk factors for non-survivals.
Thus, our study shows that neoprotein can serve as a predictive biomarker for mortality, post-SARS-CoV-2 infection. Measurement of neopterin concentration in body fluids is easily available in routine laboratories and hence can be assessed to a large number of potential patients. High neopterin levels are a hallmark of severe Covid-19 infection and should be implemented as a rapid and easy clinical tool to guide the allocation of healthcare facilities during pandemics and aid in the triage of infected patients for special medical care.
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