Elevations of serum cancer biomarkers correlate with severity of COVID-19
Main result
The average age for all patients was 64.8 ± 13.3 years. The average age for the critical and severe cases were 70.4 ± 15.7 and 69.7 ± 11.6, respectively; the patients in these groups were significantly older than those mild cases (60.1 ± 12.4) (P < 0.05). The sex ratio was variable in each category, notably > 1 in severe cases and < 1 in mild cases.
Half of the patients with severe and critical conditions had co-morbidities, such as cardiovascular disorders.
CRP increased in 95% of all cases; the increases were significant for all groups (mild: 13.5 ± 13.1; severe: 35.0 ± 39.2; critical: 66.1 ± 67.3; in mg/L; P = 0.002). Patients showed a lymphopenia with a degree associated with the disease severity (mild: 1.6 ± 0.6; severe: 1.4 ± 0.7; critical: 0.9 ± 0.5; x10^9/L; P < 0.001). IL-6 levels dramatically increased in all categories of cases but were not statistically significant.
Takeaways
Significant increase in certain cancer biomarkers, notably HE4, CYFRA21-1, CEA, CA 125 and CA 153, in proportion to CRP and severity, in COVID-19 patients a priori free of tumor pathology. This increase is consistent with previous studies suggesting an increase in some of these biomarkers in pulmonary inflammatory states. These results would require further investigation to see how these markers might reflect COVID-19-associated lung lesions and help in the prognostic assessment of patients.
Strength of evidence Moderate
Retrospective study, monocentric, gender bias for HE4 where all control patients are women, no long term follow-up of patients, no re-dosing to see a possible correlation with therapeutic response.
Objectives
Method
Retrospective study of 252 patients included, hospitalized at the Cancer Center, Union Hospital of Tongji Medical College, Wuhan between February 13 and March 3, 2020, with confirmed SARS-CoV-2, and classified into 3 groups: mild (n=131), severe (n=98), and critical (n=23). Different measurements of cancer biomarkers such as : HE4 (epididymis protein 4), CYFRA21-1 (cytokeratin-19 fragment), ACE (or CEA carcinoembryonic antigen), CA (carbohydrate antigen) 125, 153, 199, 242, 724, NSE (neuron specific enolase), AFP (alpha-foeto-protein), and SCC (squamous cell carcinoma antigen) have been carried out in these patients and compared with measurements from control subjects. The laboratory tests of control subjects were carried out in the same Center at the end of 2019 and were considered as normal.
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