engleski

Evaluation of CYFRA 21-1 levels in post-COVID-19 patients

BACKGROUND-AIM COVID-19 is an infectious disease caused by the virus called Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) that affects mainly the respiratory system, with mild symptoms in most cases, but that can also lead to critical conditions that require hospitalization. There is growing scientific evidence about the long- term effects of COVID-19 in a significant number of patients after the hospital stay. In our hospital, University Hospital Dubrava, these patients are monitored within a newly established Post-COVID Unit, and often referred to further respiratory rehabilitation regarding their decreased pulmonary function, among other complications. In this study we wanted to evaluate whether CYFRA 21-1 can be of prognostic importance in evaluation of lung injures in post-COVID patients. METHODS In our retrospective study we evaluated the levels of a well-known tumor biomarker Cytokeratin 19 fragment (CYFRA 21-1) in the serum of patients presented in the Post-COVID Unit a month or more after the end of hospitalization. For the quantitative determination of CYFRA 21-1 the Abbott’s ARCHITECT CYFRA 21-1 chemiluminescent microparticle immunoassay (CMIA) was used on the Architect i1000SR analyzer. Cytokeratin 19 is a part of the cytokeratin polypeptides family, support proteins that form the cytoskeleton of epithelial cells. CYFRA 21-1 is its serum-soluble fragment that can be detected in body fluids. It is quite frequently found in pulmonary tissue, in particular when a malignant lung tumor occurs. RESULTS CYFRA 21-1 levels were measured in 124 samples, of which 29 were above the decision limit used in our laboratory of 2.08 ng/mL, so we analyzed the available data for these 29 patients in more detail. There were 12 females and 17 males, from 82 to 49 years old, of which 7 with mild and 21 with severe symptoms and on oxygen therapy during hospitalization and unknown for one patient. None of them were on mechanical ventilation. In 26 patients a bilateral pneumonia was established during their hospital stay, and one patient was in home isolation. According to Thomas’s Clinical Laboratory Diagnostics, the decision level for patients with pulmonary disease is 3.3 ng/mL, and 12 of our patients were above this value, 10 of which with no previous history of pulmonary disease. CONCLUSION Having in mind that tumor markers are not used for diagnostic purposes, it is very unlikely that these patients are developing a lung carcinoma. However, this elevated CYFRA 21-1 levels may indicate a lung injury and therefore a greater need for future monitoring of their respiratory function.

COVID-19 ; pandemics ; post-COVID-19 ; CYFRA 21-1 ; lung fibrosis

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