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Low serum erythropoietin levels are associated with fatal COVID-19 cases at 4,150 meters above sea level
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2021-06-02 , DOI: 10.1016/j.resp.2021.103709
Antonio Viruez-Soto 1 , Mónica Marlene López-Dávalos 2 , Gabriel Rada-Barrera 2 , Alfredo Merino-Luna 3 , Daniel Molano-Franco 3 , Amílcar Tinoco-Solorozano 3 , Natalia Zubieta-DeUrioste 4 , Gustavo Zubieta-Calleja 4 , Christian Arias-Reyes 5 , Jorge Soliz 6
Affiliation  

Previous studies suggested that erythropoietin (EPO) may protect against severe COVID-19-induced injuries, ultimately preventing mortality. This hypothesis is based on the fact that, in addition to promoting the increase in red blood cells, EPO is an anti-inflammatory, anti-apoptotic and protective factor in several non-erythropoietic tissues. Furthermore, EPO promotes nitric oxide production in the hypoxic lung and stimulates ventilation by interacting with the respiratory centers of the brainstem. Given that EPO in the blood is increased at high-altitude, we evaluated the serum levels of EPO in critical patients with COVID-19 at “Hospital Agramont” in the city of El Alto (4150 masl) in Bolivia. A total of 16 patients, 15 men, one woman, with a mean age of 55.8 ± 8.49 years, admitted to the Intensive Care Unit were studied. All patients were permanent residents of El Alto, with no travel history below 3000 masl for at least one year. Blood samples were collected upon admission to the ICU. Serum EPO concentration was assessed using an ELISA kit, and a standard technique determined hemoglobin concentration. Only half of the observed patients survived the disease. Remarkably, fatal cases showed 2.5 times lower serum EPO than survivors (2.78 ± 0.8643 mU/mL vs 7.06 ± 2.713 mU/mL; p = 0.0096), and 1.24 times lower hemoglobin levels (13.96 ± 2.56 g/dL vs 17.41 ± 1.61 g/dL; p = 0.0159). While the number of cases evaluated in this work is low, our findings strongly warrant further investigation of EPO levels in COVID-19 patients at high and low altitudes. Our results also support the hypothesis that exogenous EPO administration could help critically ill COVID-19 patients overcome the disease.



中文翻译:

血清促红细胞生成素水平低与海拔 4,150 米处的致命 COVID-19 病例有关

先前的研究表明,促红细胞生成素 (EPO) 可以防止严重的 COVID-19 引起的损伤,最终防止死亡。这一假说的依据是,除了促进红细胞的增加外,EPO 在几种非红细胞生成组织中还是一种抗炎、抗凋亡和保护因子。此外,EPO 促进缺氧肺中一氧化氮的产生,并通过与脑干呼吸中枢相互作用来刺激换气。鉴于血液中的 EPO 在高海拔地区会增加,我们评估了玻利维亚埃尔阿尔托市(4150 masl)“Hospital Agramont”的 COVID-19 重症患者的 EPO 血清水平。共有 16 名患者,15 名男性,1 名女性,平均年龄为 55.8 ± 8.49 岁,入住重症监护病房。所有患者都是 El Alto 的永久居民,至少一年没有低于 3000 masl 的旅行史。血液样本在进入 ICU 时采集。使用 ELISA 试剂盒评估血清 EPO 浓度,并使用标准技术确定血红蛋白浓度。只有一半的观察患者在疾病中幸存下来。值得注意的是,死亡病例的血清 EPO 比幸存者低 2.5 倍(2.78 ± 0.8643 mU/mL 对 7.06 ± 2.713 mU/mL;p = 0.0096),血红蛋白水平低 1.24 倍(13.96 ± 2.56 g/dL 对 17.41 ± 1.61 g /dL;p = 0.0159)。虽然在这项工作中评估的病例数量很少,但我们的发现强烈证明需要进一步调查高海拔和低海拔地区 COVID-19 患者的 EPO 水平。

更新日期:2021-06-08
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