Journal of Multidisciplinary Healthcare (Jun 2025)
Insulin-Like Growth Factor Binding Protein, Acid-Labile Subunit Serum Level During the Acute and Convalescent Stage of SARS-CoV-2 Infection Depicted in a Longitudinal Study of 72 Patients During the First Wave of Pandemic
Abstract
Hossam Gad,1,* Mohamed A Mahmoud,2,* Mohamed Antar,1 Ahmed Sayed Ahmed,2 Krzysztof Laudanski3 1Department of Anesthesiology and Perioperative Care, Mayo Clinic, Rochester, MN, USA; 2Division Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA; 3Department of Anesthesiology and Critical care, University of Pennsylvania, Philadelphia, PA, USA*These authors contributed equally to this workCorrespondence: Krzysztof Laudanski, Department of Anesthesiology and Perioperative Care, Mayo Clinic, 200 1st St, Rochester, MN, 55902, USA, Tel +1 508-762-9587, Email [email protected]: Recent discoveries have pointed to the role of IGFALS immunological response to viral challenges, potentially leading to the emergence of a cytokine storm. Here, we investigate if serum IGFALS during the acute response to SARS-CoV-2 will not be likely to accompany immune response during acute phase and convalescence.Patients and Methods: We recruited patients hospitalized with PCR-confirmed SARS-CoV-2 infection in 2020 and have blood collected after securing consent (tadm), at 48 hours (t48hrs), 7 days (t7d), and after discharge from hospital (tlong). IGFALS and IGF-1 in serum were measured to assess dynamics of the illness and compared against non-specific inflammatory (C-reactive protein, IL-6) markers. Serum titers of IgG against proteins S and N assessed specific viral responses. Serum HMGB-1 was measured to assess level of necrosis. Demographic and clinical data were collected using electronic health records (EHR). Survival was determined at six months from admission.Results: No difference between serum IGFALS and IGF-1 levels was seen across the studied time points. IGFALSadm showed significant positive correlations with IGFALS48hrs (r2=0.18; p< 0.001), IGFALS7d (r2= 0.19; p=0.004), and IGFALSlong (r2 = 0.23; p=0.045). IGFALS correlated negatively with IGF-1 but positively with growth hormone. IGFALSadm showed significant inverse correlations with serum levels of HMGB1adm (r2= 0.26; p = < 0.001) and t48hr (r2 = 0.27; p< 0.001). A significant correlation in the case of IGFALS48hrs and CRP48hrs (r2 = 0.09, p = 0.021), IGFALSlong and CRPlong (r2 = 0.271, p=0.039) was seen. Similar correlations were seen at 48 hours of sampling time for IL-6 (r2 = 0.14, p=0.006). In terms of specific antiviral response, we observed that serum IGFALSadm demonstrated correlation levels of serum IgGadm (r2 = 0.09, p=0.024). A positive correlation was found between length of stay in hospital or ICU and serum IGFALS48hrs.Conclusion: Though IGFALS serum levels did not change significantly during SARS-CoV-2 infection, we observed correlations with markers of tissue destruction, C-reactive protein, IL-6, and length of hospital stay.Keywords: IGFALS, COVID-19, SARS-CoV-2, cytokine storm, IL-6, longitudinal study, infection
