Elevated plasma level of the glycolysis byproduct methylglyoxal on admission is an independent biomarker of mortality in ICU COVID-19 patients
Fadhel A. Alomar, Marai N. Alshakhs, Salah Abohelaika, Hassan M. Almarzouk, Mohammed Almualim, Amein K. Al‐Ali, Fahad Al‐Muhanna, Mohammed F. Alomar, Mousa J Alhaddad, Mohammed S. Almulaify, Faisal S. Alessa, Ahmed S. Alsalman, Ahmed Alaswad, Sean R. Bidasee, Hassan A. Alsaad, Rudaynah A. Alali, Mona Hmoud AlSheikh, Mohammed Akhtar, Mohammad Al Mohaini, Abdulkhaliq J. Alsalman, Hussain R. Alturaifi, Keshore R. Bidasee
Abstract
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 ( r 2 = − 0.50), and its co-factor glutathione ( r 2 = − 0.63), and positively with monocytes ( r 2 = 0.29). The inflammation markers, SSAO ( r 2 = 0.52), TNF-α ( r 2 = 0.41), IL-1β ( r 2 = 0.25), CRP ( r 2 = 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.