ORIGINAL ARTICLE   

Minerva Endocrinology 2022 September;47(3):270-8

DOI: 10.23736/S2724-6507.22.03789-7

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Serum galectin-3 and aldosterone: potential biomarkers of cardiac complications in patients with COVID-19

Alessandro CANNAVO ¹, Daniela LICCARDO ², Monica GELZO ^{3, 4}, Felice AMATO ^{3, 4}, Ivan GENTILE ⁵, Biagio PINCHERA ⁵, Grazia D. FEMMINELLA ¹, Roberto PARRELLA ⁶, Annunziata DE ROSA ⁶, Giuseppina GAMBINO ¹, Federica MARZANO ⁷, Nicola FERRARA ^{1, 8}, Nazareno PAOLOCCI ^{9, 10}, Giuseppe RENGO ^{1, 8} ✉, Giuseppe CASTALDO ^{3, 4}

¹ Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy; ² Center for Translational Medicine, Temple University, Philadelphia, PA, USA, 3 Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; ⁴ CEINGE-Biotecnologie Avanzate S.c.a.r.l., Naples, Italy; ⁵ Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; ⁶ Respiratory Infectious Diseases Unit, Cotugno Hospital-A.O.R.N. dei Colli, Naples, Italy; ⁷ Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; ⁸ Istituti Clinici Scientifici ICS Maugeri IRCCS, Telese Terme, Benevento, Italy; ⁹ Division of Cardiology, Johns Hopkins University Medical Institutions, Baltimore, MD, USA; ¹⁰ Department of Biomedical Sciences, University of Padua, Padua, Italy

BACKGROUND: Despite severe acute respiratory syndrome (SARS)-Coronavirus (CoV-2) primarily targeting the lungs, the heart represents another critical virus target. Thus, the identification of SARS-CoV-2 disease of 2019 (COVID-19)-associated biomarkers would be beneficial to stratify prognosis and the risk of developing cardiac complications. Aldosterone and galectin-3 promote fibrosis and inflammation and are considered a prognostic biomarker of lung and adverse cardiac remodeling. Here, we tested whether galectin-3 and aldosterone levels can predict adverse cardiac outcomes in COVID-19 patients.
METHODS: To this aim, we assessed galectin-3 and aldosterone serum levels in 51 patients diagnosed with COVID-19, using a population of 19 healthy subjects as controls. In in-vitro studies, we employed 3T3 fibroblasts to assess the potential roles of aldosterone and galectin-3 in fibroblast activation.
RESULTS: Serum galectin-3 levels were more elevated in COVID-19 patients than healthy controls and correlated with COVID-19 severity classification and cardiac troponin-I (cTnI) serum levels. Furthermore, we observed an augmented secretion of aldosterone in COVID-19 patients. This adrenal hormone is a direct stimulator of galectin-3 secretion; therefore, we surmised that this axis could perpetrate fibrosis and adverse remodeling in these subjects. Thus, we stimulated fibroblasts with 10% of serum from COVID-19 patients. This challenge markedly rose the expression of smooth muscle alpha (α)-2 actin (ACTA2), a myofibroblast marker.
CONCLUSIONS: Our study suggests that COVID-19 can affect cardiac structure and function by triggering aldosterone and galectin-3 release that may serve as prognostic and therapeutic biomarkers while monitoring the course of cardiac complications in patients suffering from COVID-19.

KEY WORDS: COVID-19; Complications; Galectin 3; Aldosterone