The Role Of Serum Prolidase Activity, MMP-1, MMP-7, TGF- β Values In Prediction Of Early Fibrosis In Patients With Moderate And Severe Covid-19

Abstract Background This study aimed to identify predictive factors for pulmonary fibrosis development in COVID-19 patients by analysing thorax CT (Computed tomography) findings, serum prolidase activity, MMP-1, MMP-7, TGF-β values, laboratory findings, and demographic characteristics. Materials and methods The investigation involved 68 patients, both male and female, aged 18 years and older, who were volunteers and had been diagnosed with confirmed or possible COVID-19. Thorax CT were evaluated by common consensus by the pulmonologist and the radiologist. Patients were evaluated in two categories, group 1 and group 2, according to the status of fibrotic changes, and 3-month fibrosis scores were calculated. These findings in both lungs were calculated and noted for the lobes, considering lobar spread. Correlations between quantitative parameters were assessed with Spearman's rho correlation coefficient. Comparisons between independent samples were carried out with an independent sample t-test or Mann-Whitney U test. The Pearson chi-square test and Fisher's exact test were used to evaluate the relationship between categorical variables. Results Serum prolidase activity, MMP-1, MMP-7 and TGF-β biomarkers were not statistically significant among groups. LDH was found to be significantly high in the group with fibrotic changes. Additionally, the group with fibrotic changes also had higher levels of fibrinogen. The percentage of neutrophils, the severity of the disease, muscle-joint pain and fatigue symptoms, and the duration of the hospital stay were correlated with the total scores of fibrosis at the 3rd month. In the group with fibrotic changes, muscle-joint pain and fatigue symptoms and the duration of hospital stay were longer than the other group. Conclusions The group with fibrotic changes showed an increase in biomarkers. However, this increase did not reach a statistically significant level, suggesting that the third month may be an early period for these changes. The group with fibrotic changes showed high levels of LDH, one of the most important laboratory parameters of pulmonary fibrosis risk factors, along with fibrinogen, suggesting that these parameters are valuable in predicting pulmonary fibrosis. Patients with fibrotic changes can experience specific symptoms, commonly seen in COVID-19. Trial registration Thaiclinicaltrials.org, TCTR20240701005, retrospectively registered on 24 June 2024.