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Association of Serum Complement C3 Levels with Severity and Mortality in COVID 19

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Abstract

The severe acute respiratory distress syndrome-associated coronavirus-2 infection can activate innate and adaptive immune responses which may lead to harmful tissue damage, both locally and systemically. C3, a member of complement system of serum proteins, is a major component of innate immune and inflammatory responses. This study is aimed to assess serum C3 as a marker of COVID-19 severity and a predictor of disease progression. A total of 150 COVID-19 patients, confirmed by RT-PCR, and 50 healthy controls were recruited. Serum C3 levels were determined by using direct colorimetric method. Median levels of serum C3 in total cases and controls were 157.8 and 165.7 mg/dL respectively. Serum C3 although not significantly decreased, they were lower in cases when compared to controls. Similarly, significant differences were found between the groups, with severe group (140.6 mg/dL) having low levels of serum C3 protein when compared to mild (161.0 mg/dL) and moderate group (167.1 mg/dL). Interestingly, during hospitalization, significant difference between baseline (admission) and follow-up (discharge) was observed only in patients with moderate disease. Based on our results, lower levels of C3, with an increase in IL-6 and d-dimer levels, are associated with higher odds of mortality. Therefore, we would like to emphasize that measuring serum C3 levels along with other inflammatory markers might give an added advantage in early identification of patients who are prone to having a severe disease course and can help in a more effective follow-up of disease progression.

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All-India Institute of Medical Sciences Jodhpur

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Authors and Affiliations

  1. Department of Biochemistry, All India Institute of Medical Sciences (AIIMS) Jodhpur, Basni Phase 2, Jodhpur, Rajasthan, 342005, India

    Sojit Tomo, Dharamveer Yadav, Shrimanjunath Sankanagoudar, Praveen Sharma & Purvi Purohit

  2. Department of Biochemistry, Andhra Medical College, Visakhapatnam, India

    PVSN Kiran Kumar

  3. Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India

    Jayakaran Charan

  4. Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India

    Abhishek Purohit

  5. Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India

    Vijaya Lakshmi Nag

  6. Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India

    Pradeep Kumar Bhatia

  7. Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, India

    Kuldeep Singh

  8. Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, India

    Naveen Dutt

  9. Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, India

    Mahendra Kumar Garg

  10. Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India

    Sanjeev Misra

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  1. Sojit Tomo
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  2. PVSN Kiran Kumar
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Contributions

Conceptualisation: PP, DY, SS; Material preparation, data collection and analysis: PKK, PP, SS, DY. Manuscript first draft preparation: PKK, PP, SS, DY; Writing, review and editing: PKK, PP, ST, DY, SS, JC; Sample testing: PKK, ST, AP, VLN; Patient recruiting: PKKND, PKB; Supervision: KS, MKG, SM and PS.

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Correspondence to Purvi Purohit.

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Ethical Approval

The study was conducted as per the Declaration of Helsinki and approved by the institutional ethics committee of the All India Institute of Medical Sciences, Jodhpur, India. (Ethical approval number: AIIMS/IEC/2020–21/1090).

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All the participants were recruited after obtaining written informed consent. For participants that could not provide consent, consent on their behalf accordingly from the near family relative (Spouse/Parents) available at that time. All authors read and approved the final manuscript.

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Tomo, S., Kiran Kumar, P., Yadav, D. et al. Association of Serum Complement C3 Levels with Severity and Mortality in COVID 19. Ind J Clin Biochem 38, 447–456 (2023). https://doi.org/10.1007/s12291-023-01148-x

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  • DOI: https://doi.org/10.1007/s12291-023-01148-x

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