Evaluation of alpha defensin, IL‐1 receptor antagonist, and IL‐18 levels in COVID‐19 patients with macrophage activation syndrome and acute respiratory distress syndrome

Kerget, Buğra; Kerget, Ferhan; Aksakal, Alperen; Aşkın, Seda; Sağlam, Leyla; Akgün, Metin

BACKGROUND: Many laboratory parameters have been associated with morbidity and mortality in SARS‐CoV‐2 (COVID‐19), which emerged in an animal market in Wuhan, China in December 2019 and has infected over 20 million people. This study investigated the relationship between serum interleukin (IL)‐18, IL‐1 receptor antagonist (IL‐1Ra), and alpha defensin levels and the clinical course and prognosis of COVID‐19. MATERIALS AND METHODS: This study included 100 patients who were admitted to the chest diseases department and intensive care unit of our hospital and diagnosed with COVID‐19 by real‐time polymerase chain reaction (PCR) of nasopharyngeal swab samples between March 24 and May 31, 2020. The control group consisted of 50 nonsymptomatic health workers with negative real‐time PCR results in routine COVID‐19 screening in our hospital. RESULTS: Serum alpha defensin, IL‐1Ra, and IL‐18 levels were significantly higher in patients who developed macrophage activation syndrome (MAS) and acute respiratory distress syndrome (ARDS) compared to patients who did not (p < .001 for all). Alpha defensin, IL‐1Ra, and IL‐18 levels were significantly higher in COVID‐19 patients with and without MAS or ARDS when compared to the control group (p < .001 for all). When the 9 patients who died were compared with the 91 surviving patients, IL‐1Ra and IL‐18 levels were found to be significantly higher in the nonsurvivors (p < .001). CONCLUSION: Our findings of correlations between alpha defensin and levels of IL‐1Ra and IL‐18, which were previously shown to be useful in COVID‐19 treatment and follow‐up, indicates that it may also be promising in treatment.