Demystifying the role of MMP9 and TIMP-1 as markers of lung imaging and functional abnormality of COVID-19

Abstract

Introduction: This study aimed to analyze the levels of MMP-9 and TIMP-1 as biomarkers for identifying lung anatomical and functional abnormalities in coronavirus disease 2019 (COVID-19).

Methodology: Adult COVID-19 patients hospitalized between October and December 2021 were included in the study. MMP-9 and TIMP-1 levels were measured from the blood. Chest X-ray was categorized using the Brixia index. A blood gas analysis was performed in the emergency room.

Results: MMP-9 was higher in severe COVID-19 patients (1,430.09 ± 1,492.22) than in non-severe cases (819.90 ± 750.13) with p < 0.05, but not different between mortality groups. TIMP-1 was lower in non-severe cases (4.88 ± 3.49) than in severe cases (8.61 ± 9.09) with p > 0.05. The increase in MMP-9 was correlated to TIMP-1 with a linear regression value R² = 0.945. Lung abnormalities were categorized as normal (6.9%), mild (23.6%), moderate (29.2%), and severe (40.3%). Brixia score was significantly correlated with FiO₂ (r = 0.547), PaO₂/FiO₂ (r = – 0.317), and SpO₂/FiO₂ (r = – 0.476). MMP-9 and TIMP-1 were significantly correlated with the Brixia score (r = 0.315 and r = – 0.234, respectively), and PaO₂/FiO₂ (r = – 0.291 and r = 0.283, respectively). MMP-9 was significantly correlated with severity (r = 0.313).

Conclusion: MMP-9 and TIMP-1 were related to lung imaging, functional abnormalities, and severity; but were not associated with mortality.