C-terminal cross-linking telopeptide levels in COVID-19 patients: A prospective case-control study

Adv Clin Exp Med. 2024 Jul;33(7):691-698. doi: 10.17219/acem/185254.

Abstract

Background: Coronavirus disease 19 (COVID-19) is a viral infection mediated by coronavirus-2 that causes severe acute respiratory syndrome (SARS-CoV-2). The disease may affect biochemical parameters and electrolytes. C-terminal cross-linking telopeptide (CTX-I) is released during mature bone resorption and is a biomarker for predicting bone resorption.

Objectives: As the pandemic progressed, understanding the effects of COVID-19 disease remained critical. Inflammatory responses triggered by the virus can result in a bone metabolism regulation imbalance. As such, this study aimed to analyze serum levels of CTX-I, calcium (CA), phosphorus (P), magnesium (Mg), C-reactive protein (CRP), and alkaline phosphatase (ALP) in COVID-19 patients to investigate the relationship between bone resorption and the disease.

Material and methods: The study included 56 individuals with COVID-19 (divided into mild, moderate and severe subgroups depending on disease severity) and 25 healthy adults as a control group. Serum CTX-I concentrations were measured with enzyme-linked immunosorbent assay (ELISA). In addition, CRP, Ca, Mg, P, and ALP levels were measured using an automated clinical chemistry analyzer.

Results: Serum CTX-I levels were significantly higher in COVID-19 patients than in the control group (p < 0.05). Furthermore, a positive weak relationship was detected between CRP and CTX-I (r = 0.303, p < 0.05).

Conclusions: Increased serum CTX-I levels in the patient group caused COVID-19-driven bone degradation, though serum CTX-I levels did not differ according to disease severity.

Keywords: COVID-19; CTX-I; bone.

MeSH terms

  • Adult
  • Aged
  • Alkaline Phosphatase / blood
  • Biomarkers* / blood
  • Bone Resorption / blood
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • COVID-19* / blood
  • COVID-19* / diagnosis
  • Calcium / blood
  • Case-Control Studies
  • Collagen Type I* / blood
  • Female
  • Humans
  • Magnesium / blood
  • Male
  • Middle Aged
  • Peptides* / blood
  • Phosphorus / blood
  • Prospective Studies
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • collagen type I trimeric cross-linked peptide
  • Biomarkers
  • Collagen Type I
  • C-Reactive Protein
  • Peptides
  • Alkaline Phosphatase
  • Calcium
  • Magnesium
  • Phosphorus