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Abstract
Biomarkers to identify ICU COVID-19 patients at high risk for mortality are urgently needed for therapeutic care and management. Here we found plasma levels of the glycolysis byproduct methylglyoxal (MG) were 4.4-fold higher in ICU patients upon admission that later died (n = 33), and 1.7-fold higher in ICU patients that survived (n = 32),compared to uninfected controls (n = 30). The increased MG in patients that died correlated inversely with the levels of the MG-degrading enzyme glyoxalase-1 (r2 = − 0.50), and its co-factor glutathione (r2 = − 0.63), and positively with monocytes (r2 = 0.29). The inflammation markers, SSAO (r2 = 0.52), TNF-α (r2 = 0.41), IL-1β (r2 = 0.25), CRP (r2 = 0.26) also correlated positively with MG. Logistic regression analysis provides evidence of a significant relationship between the elevated MG upon admission into ICU and death (P < 0.0001), with 42% of the death variability explained. From these data we conclude that elevated plasma MG on admission is a novel independent biomarker that predicts mortality in ICU COVID-19 patients.
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1 Imam Abdulrahman Bin Faisal University, Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Dammam, Saudi Arabia (GRID:grid.411975.f) (ISNI:0000 0004 0607 035X)
2 Dammam Medical Complex, Department of Internal Medicine, Dammam, Saudi Arabia (GRID:grid.411975.f)
3 Qatif Central Hospital, Ministry of Health, Clinical Pharmacology Department, Qatif, Saudi Arabia (GRID:grid.415458.9) (ISNI:0000 0004 1790 6706)
4 Dammam Medical Complex, Department of Internal Medicine, Dammam, Saudi Arabia (GRID:grid.415458.9)
5 Qatif Central Hospital, Ministry of Health, Intenstive Care Unit, Qatif, Saudi Arabia (GRID:grid.415458.9) (ISNI:0000 0004 1790 6706)
6 Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia (GRID:grid.411975.f) (ISNI:0000 0004 0607 035X)
7 University of Nebraska Medical Center, Departments of Pharmacology and Experimental Neuroscience, Omaha, USA (GRID:grid.266813.8) (ISNI:0000 0001 0666 4105)
8 King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Basic Sciences Department, College of Applied Medical Sciences, Al Ahsa, Saudi Arabia (GRID:grid.412149.b) (ISNI:0000 0004 0608 0662)
9 Northern Border University, Department of Clinical Pharmacy, Faculty of Pharmacy, Rafha, Saudi Arabia (GRID:grid.449533.c) (ISNI:0000 0004 1757 2152)
10 King Fahad Hospital Hofuf, Alahsa, Saudi Arabia (GRID:grid.415294.f) (ISNI:0000 0004 0417 2352)