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

F. Lima1, C. Peachazepi de Moraes2, M. Silva Barbosa1, B. Bombassaro1, A. Palma1, E. Mansur3, L. Velloso1, E. de Paula3

1University of Campinas, Campinas, Sao Paulo, Brazil, 2University of Campinas, Campinas, South Carolina, United States, 3School of Medical Sciences of the University of Campinas, Campinas, Sao Paulo, Brazil

Abstract Number: PB0599

Meeting: ISTH 2022 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Basic Science

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.

Image

Figure 1. Levels of -a- HO-1, -b- hemopexin, -c- heme and -d- hemoglobin in COVID-19 patients and healthy volunteers; Time-course of -e- HO-1 -f- hemopexin in the early phases of COVID-19.

Table

Table 1. Association of HO-1 levels on admission and markers of coagulation and fibrinolysis activation in COVID-19

To cite this abstract in AMA style:

Lima F, Peachazepi de Moraes C, Silva Barbosa M, Bombassaro B, Palma A, Mansur E, Velloso L, de Paula E. Association of heme/hemopexin/heme-oxygenase 1 pathway with clinical and laboratory markers of severity in Covid-19 [abstract]. https://abstracts.isth.org/abstract/association-of-heme-hemopexin-heme-oxygenase-1-pathway-with-clinical-and-laboratory-markers-of-severity-in-covid-19/. Accessed September 21, 2023.

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