Silva, Gabriele Amorim; Amorim, Gabriele; 0009-0003-6028-9766; http://lattes.cnpq.br/5461924181039142
Resumo:
Predicting the severity and prognosis of COVID-19 through feasible biomarkers remains
challenging for the scientific community. This study aims to identify in the literature evidence
of the contribution of osteopontin (OPN) in the early assessment of the severity of COVID-19,
its potential as a predictor of unfavorable outcomes, and to identify its correlation with other
cytokines of the immune response. Two articles make up this volume: A systematic review
composed of 13 articles, involving adult and pediatric participants, that investigated osteopontin
as a marker of severity, prognosis, mortality, and immunopathogenesis aspects in COVID-19.
The studies were carried out in Europe, Asia, and North America, and a gap in the behavior of
this biomarker was evidenced in populations of developing countries. The outcomes evaluated
indicate that OPN plays a role in the immunopathogenesis of COVID-19, identifies different
levels of severity, and predicts poor prognosis. The OPN cut-off points for distinguishing
severity and prognosis were different and difficult to compare between studies, reiterating the
need for further investigations. The second article presents an evaluation of a prospective
cohort, with participants ≥18 years old, with a confirmed diagnosis of COVID-19, admitted to
the ICU of a Hospital in the Northeast of Brazil. The association of OPN with clinical and
immunological parameters was performed using Poisson regression with robust variance. The
OPN cutoff point at admission for the prognosis of death was estimated using the ROC curve.
Of the 52 participants, 55.8% were male and 63.5% were 60 or older. The OPN cut-off point at
admission was ≥31.0 ng/ml (AUC:0.743). High OPN at admission was associated with
prognosis death (RR: 2.31, 95% CI: 1.34-3.98), severe anemia (RR: 1.67, 95% CI: 1.03-2.70),
and elevated CRP ≥173.5 mg/dL (RR: 2.46, 95% CI: 1.34-4.52). The positively correlated
immunological markers significantly associated with OPN at admission were IL-1β, IL-2, TGF β, and IFN-γ. Elevated osteopontin at admission emerged as a good marker of unfavorable
prognosis at admission and after 5 days in the ICU. The associated immunological signatures
of high OPN (≥31.0ng/ml) at admission favor hyperinflammatory responses, promote the
migration and activation of macrophages and T cells, and a receptive microenvironment for
pro-inflammatory and pro-fibrotic actions. Conclusion: In the population analyzed, OPN
proved to be an important biomarker of unfavorable prognosis and higher mortality in COVID 19. OPN has an important relationship with inflammatory response, lasting longer as a predictor
until the 5th day after ICU admission. Further studies are needed to better understand OPN with
other cytokines and the longevity of this biomarker in long COVID.
