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

DOI: 10.23736/S2724-6507.22.03789-7


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

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