Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 224, Issue 1, Pages 21-30Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab113
Keywords
SARS-CoV-2; COVID-19; influenza A(H1N1)pdm09; acute respiratory distress syndrome; surfactant protein D
Categories
Funding
- Consejo Nacional de Ciencia y Tecnologia (CONACyT) [CVU 737347, 313517, 00311999]
- Secretaria de Ciencia, Tecnologia e Innovacion de la Ciudad de Mexico [SECTEI/050/2020]
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas
- Fondo Institucional de Fomento Regional para el Desarrollo Cientifico y Tecnologico y de Innovacion [FORDECYT/10SE/2020/05/14-07]
- Barnes Jewish Hospital Foundation
- Washington University Institute of Clinical and Translational Sciences
- Washington University in St Louis
- NIH [R01AI123780, R01AI134236, 3R01AI134236-04W1]
- National Center for Advancing Translational Sciences, NIH [UL1TR002345]
- Universidad Nacional Autonoma de Mexico [43355-3065-17-XI-15]
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Surfactant protein D (SP-D) may help differentiate severe pandemic influenza from COVID-19, with high serum SP-D levels possibly associated with death and renal failure in severe pandemic influenza cases. However, SP-D levels do not distinguish seasonal influenza from COVID-19 in mild-to-moderate disease.
The differentiation between influenza and coronavirus disease 2019 (COVID-19) could constitute a diagnostic challenge during the ongoing winter owing to their clinical similitude. Thus, novel biomarkers are required to enable making this distinction. Here, we evaluated whether the surfactant protein D (SP-D), a collectin produced at the alveolar epithelium with known immune properties, was useful to differentiate pandemic influenza A(H1N1) from COVID-19 in critically ill patients. Our results revealed high serum SP-D levels in patients with severe pandemic influenza but not those with COVID-19. This finding was validated in a separate cohort of mechanically ventilated patients with COVID-19 who also showed low plasma SP-D levels. However, plasma SP-D levels did not distinguish seasonal influenza from COVID-19 in mild-to-moderate disease. Finally, we found that high serum SP-D levels were associated with death and renal failure among severe pandemic influenza cases. Thus, our studies have identified SP-D as a unique biomarker expressed during severe pandemic influenza but not COVID-19.
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