PB0599 - Association of heme/hemopexin/heme-oxygenase 1 pathway with clinical and laboratory markers of severity in Covid-19

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Franciele Lima

PhD student
University of Campinas
Campinas, Sao Paulo, Brazil

Co-Author(s)

CR

Carla Roberta Peachazepi Moraes

PhD student
University of Campinas
Campinas, Sao Paulo, Brazil
MB

Mayck Barbosa

Student
University of Campinas
Campinas, Sao Paulo, Brazil
BB

Bruna Bombassaro

PhD
University of Campinas
Campinas, Sao Paulo, Brazil
AP

André C. Palma

Physician
University of Campinas
Campinas, Sao Paulo, Brazil
EM

Eli Mansur

Professor
School of Medical Sciences of the University of Campinas
Campinas, Sao Paulo, Brazil
LV

Licio A. Velloso

Professor
University of Campinas
Campinas, Sao Paulo, Brazil
EV

Erich V. Vinicius de Paula

Professor
University of Campinas
Campinas, Sao Paulo, Brazil

Background: Heme-oxygenase 1 (HO-1) is an intracellular enzyme that is part of a broad anti-inflammatory and antioxidative pathway, in which it metabolizes heme delivered to cells by hemopexin. Although initial suggestions of a direct action of SARS-CoV-2 on hemoglobin or heme have already been refuted, HO-1 activation is recognized as part of the host response and as a potential therapeutic target in several diseases involving thrombosis and inflammation.

Aims: To evaluate circulating levels of hemopexin, heme and HO-1 in COVID-19, and their association with clinical and laboratory markers of disease severity.

Methods: Thirty consecutive patients with confirmed COVID-19 admitted due to hypoxemia were enrolled, along with 30 age and sex-matched healthy volunteers. HO-1 and hemopexin were measured by ELISA, and heme was measured by a colorimetric method. Samples were obtained on admission. Coagulation and inflammatory biomarkers were measured using commercional kits.

Results: HO-1 levels were higher in patients compared to healthy volunteers, and a trend towards higher hemopexin levels was also observed. In contrast heme levels were similar in patients and controls. A significant decrease in HO-1 levels was observed at the 4th day of hospital stay, and the magnitude of this decrease (HO-1) was correlated with the number of days in intensive care. Moreover, admission HO-1 levels were correlated with several biomarkers of hemostasis and fibrinolysis activation.

Conclusion(s): Upregulation of HO-1 is observed in COVID-19. HO-1 levels on admission were associated with markers of coagulation and fibrinolysis activation. Persistance of high HO-1 levels during admssion was associated with longer ICU stay.