Diagnostic and Prognostic Value of SCUBE-1 in COVID-19 Patients

Introduction: The workload of physicians increased due to the number of patients presenting with suspicion of coronavirus 2019 (COVID-19) and the prolonged wait times in the emergency department during the COVID-19 pandemic. Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) is a protein present in platelets and endothelial cells; it is activated by inflammation from COVID-19 and may be associated with COVID-19’s known thrombotic risk. We aimed to determine whether SCUBE-1 levels are diagnostically correlated in suspected COVID-19 patients, and whether SCUBE-1 correlated with severity of disease and, therefore, might be useful to guide hospitalization/discharge decisions. Methods: The suspected COVID-19 patients cared for at tertiary healthcare institutions for one year between May 2021–May 2022 were examined in this study. The subjects were both suspected COVID-19 patients not ultimately found to have COVID-19 and those who were diagnosed with COVID-19. By modifying the disease severity scoring systems present in COVID-19 guidelines in 2021, the COVID-19-positive patient group was classified as mild, moderate, severe, and critical, and compared using the SCUBE-1 levels. Moreover, SCUBE-1 levels were compared between the COVID-19 positive group and the COVID-19 negative group. Results: A total of 507 patients were considered for the present study. After excluding 175 patients for incomplete data and alternate comorbid organ failure. we report on 332 patients (65.5%). Of these 332 patients, 80 (24.0%) were COVID-19 negative, and 252 (76.0%) were COVID-19 positive. Of 252 (100%) patients diagnosed with COVID-19, 74 (29.4%) were classified as mild, 95 (37.7%) moderate, 45 (17.8%) severe, and 38 (15.1%) critical. The SCUBE-1 levels were statistically different between COVID-19 positive (8.48 ± 7.42 nanograms per milliliter [ng/mL]) and COVID-19 negative (1.86 ± 0.92 ng/mL) patients (P < 0.001). In the COVID-19 positive group, SCUBE-1 levels increased with disease severity (mild = 3.20 ± 1.65 ng/mL, moderate = 4.78 ± 2.26 ng/mL, severe = 13.68 ± 3.95 ng/mL, and critical = 21.87 ± 5.39 ng/mL) (P < 0.001). The initial SCUBE-1 levels of discharged patients were significantly lower than those requiring hospitalization (discharged = 2.89 ng/mL [0.55–8.60 ng/mL]; ward admitted = 7.13 ng/mL [1.38–21.29 ng/mL], and ICU admitted = 21.19 ng/mL [10.58–37.86 ng/mL]) (P < 0.001). Conclusion: The SCUBE-1 levels were found to be differentiated between patients with and without COVID-19 and to be correlated with the severity of illness

The Diagnostic Value of ischemia-modified albumin (IMA) and signal peptide-CUB-EGF domain-containing protein-1 (SCUBE-1) in an Experimental Model of Strangulated Mechanical Bowel Obstruction

Background Mechanical bowel obstruction (MBO) is one of the principal pathologies requiring emergency surgery and a significant worldwide cause of morbidity. The identification of patients in whom bowel obstruction resolves spontaneously is important in terms of preventing unnecessary surgical interventions and future potential adhesions. The decision-making process is difficult in patients presenting without classic examination findings. Methods 36 female Sprague-Dawley rats randomly divided into six experimental groups. In Group 1, 3 and 5, laparotomy was performed, with blood and tissue specimens being collected after 1, 2 and 6 h, respectively. In Group 2, 4 and 6, the ileum segment was ligated following laparotomy, and blood and tissue specimens were collected after 1, 2 and 6 h, respectively. The ileum specimens were examined macroscopically, after which 1-cm sections were taken and examined in terms of histopathological changes. IMA and SCUBE-1 levels were determined for each group, and macro- and microscopic tissue examination findings were compared between the groups. Results Comparison within the groups exposed to waiting times of 1 h (groups 1 and 2), 2 h (groups 3 and 4) and 6 h (groups 5 and 6) revealed higher mean IMA and SCUBE-1 levels in rats undergoing ligation together with incision (groups 2, 4, and 6) compared to those undergoing laparotomy only (groups 1, 3, and 5). Correlation analysis was applied to determine the relationship between total scores obtained from histopathological examination and IMA and SCUBE-1 values. The analysis revealed strong, significant and positive correlation between histopathological examination scores and IMA (r=0.643, p=0.000) and SCUBE-1 (r=0.509, p=0.002) values. Conclusion The study findings showed that both IMA and SCUBE-1 values increased in a strangulated MBO model in rats. We think that IMA and SCUBE-1 values can be used as a markers of damage in the early period in strangulated MBO, and that the patient's surgery requirement can thus be determined in the early period