Monica Gelzo, Sara Cacciapuoti, Biagio Pinchera, Annunziata De Rosa, Gustavo Cernera, Filippo Scialò, Marika Comegna, Mauro Mormile, Gabriella Fabbrocini, Roberto Parrella, Gaetano Corso, Ivan Gentile, Giuseppe Castaldo, Gelzo, M., Cacciapuoti, S., Pinchera, B., De Rosa, A., Cernera, G., Scialo, F., Comegna, M., Mormile, M., Fabbrocini, G., Parrella, R., Corso, G., Gentile, I., and Castaldo, G.
The molecular basis of the wide clinical heterogeneity of Coronavirus disease 2019 (COVID-19) is still unknown. Matrix metalloproteinases (MMPs) may have a role in the lung damage and regeneration that occur in severe patients. We studied serum MMP3 and MMP9 as potential biomarkers of COVID-19 severity, in 108 hospitalized patients with different World Health Organization (WHO) severity stage and in 48 controls. At hospital admission, serum MMP3 was increased in COVID-19 patients with a significant trend along the progression of the WHO stage, while serum levels of MMP9 were significantly increased in COVID-19 patients with no correlation with disease severity. At 1 week from hospitalization, MMP3 was reduced, suggesting an early pathogenic role of the protein in lung inflammation, while MMP9 levels were further increased, indicating a late role of the protein in the inflammatory process, specifically during the repairing phase. Furthermore, serum MMP9 was positively correlated with serum interleukin-6, myeloperoxidase, and circulating neutrophils and monocytes number. In conclusion, serum MMP3 may help to early predict the severity of COVID-19 and both proteins, MMP3 and MMP9, may contribute to define severe COVID-19 patients that may benefit from a targeted therapy on MMPs.