Investigation of the effect of serum gasdermin d levels on clinical course and mortality in patients with covid-19

Abstract

Background: Cytokine storm is among the pathogenetic mechanisms in patients with severe Coronavirus Disease 2019 (COVID-19). Pyroptosis, a form of programmed cell death, is thought to play an important role in cytokine storms. Gasdermin D (GSDMD) is the principal protein involved in this pathway. This study aimed to investigate the effect of serum levels of GSDMD on clinical course and mortality in patients with COVID-19. Methods: This study was designed as an observational, prospective, non-interventional and single-center study, and patients admitted to pandemic intensive care units, wards, and outpatient clinics between December 2020 and August 2021 were included in the study. The study population consisted of 165 patients. The patients were divided into four groups: those admitted to the outpatient clinic (n = 23), those who were followed up on the ward (n = 86), those hospitalized in the intensive care unit (n = 36), and healthy controls (n = 20). Human Gasdermin D ELISA kits (FineTest®) were used to detect Gasdermin D from patients’ serum samples. Results: High Gasdermin D levels in patients with COVID-19 were associated with the need for intensive care, MV, NIMV, increased need for steroids, and mortality. With ROC analysis, Gasdermin D values of 1.45 ng/mL and above were found to be significant in indicating MAS with 63.4% sensitivity and 69.2% specificity (p = 0.002). Conclusions: Gasdermin D which is the main protein of pyroptosis, has been the subject of much research in recent years. Our study demonstrated that GSDMD may serve as a useful biomarker for predicting disease progression in patients with COVID-19.