BACKGROUND: Covid-19 infection was declared a global pandemic by WHO on March 11, 2020. GRP78 protein is known to be involved in the intrusion of numerous viruses. Our current study tries to provide some insight into the variation of GRP78 protein levels in patients with Covid-19 (-) pneumonia, Covid-19 (+) pneumonia, and CT negative Covid-19 infection in comparison to the normal population through a larger number of cases.
METHODS: 42 patients who have Covid-19 (-) pneumonia; 72 patients who have Covid-19 infection (30 pneumonia,42 CT negative patients) and 30 patient who have no known diseases (control group) have included in the study after the clinical and radiological evaluation. Serum GRP78 levels of the subjects were measured through a commercially available enzyme-linked immunosorbent assay (ELISA) kit.
RESULTS: The GRP78 level was found to be significantly higher in the Covid-19 infection group than both Covid-19 (-) pneumonia and control group (p = 0.031 and p = 0.0001, respectively).No significant difference was evident between Covid-19 (-) pneumonia, Covid-19 (+) pneumonia and CT negative Covid 19 infection groups with respect to GRP78 levels (p = 0.09). In addition, the GRP78 levels were significantly higher in the Covid-19 (-) pneumonia group than the control group (p = 0.0001).
CONCLUSIONS: This prospective case-control study reveals that the serum GRP78 levels significantly increased during Covid-19 infection in comparison to both the Covid-19 (-) pneumonia and the control group. As the association between SARS-CoV-2 virus and GRP78 protein is revealed more clearly, this association may come to the fore as a therapeutic target.

OBJECTIVE: A novel human coronavirus, named SARS-COV-2, has recently caused thousands of deaths all around the world. Endoplasmic reticulum (ER) stress plays an important role in the development of diseases.
METHODS: We aimed to to investigate the relationship between ER stress markers in patients infected with SARS-COV-2 and patients with pneumonia. A total of 9 patients (4 patients diagnosed with pneumonia and 5 patients diagnosed with SARS-COV-2 infection) who admitted to the emergency Department with symptoms of pneumonia and SARS-COV-2 were included in the study. A total of 18 healthy individuals without any known chronic or acute disease and drug use were included as the healthy control group. Serum human glucose regulated protein 78 (GRP78), serum human C/EBP homologous protein (CHOP) and serum human phospho extracellular signal regulated kinase (PERK) levels were measured using enzyme-linked immunosorbent assay (ELISA).
RESULTS: GRP78 levels were found to be significantly higher in SARS-COV-2 positive cases compared to individuals in other groups. Serum GRP-78 level median value was statistically significantly higher in SARS-COV-2-positive group compared to the other groups (p=0.0003). Serum PERK level was statistically significantly higher in SARS-COV-2-positive pneumonia cases (p=0.046).
CONCLUSIONS: An association was shown between GRP78 and SARS-COV-2 infection. Although a small number of patients was investigated, these results will be important and guide future treatments of SARS-COV-2.

OBJECTIVE: The purpose of this study was to determine the value of the endoplasmic reticulum (ER) stress markers glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP) and PERK in predicting the success of cardiopulmonary resuscitation (CPR) or post-CPR survival.
METHODS: Non-traumatic out-of-hospital CA patients were included in this prospective, nested case-control study. Standard CPR and post-resuscitative care were applied. Levels of ER stress markers were measured at presentation and were investigated to determine whether they might constitute a marker predicting return of spontaneous circulation (ROSC) or sustained ROSC, and of 24-h, and 1 and 3-month survival.
RESULTS: Fifty-two out of 99 non-traumatic CA patients were enrolled. ROSC was determined at a level of 25%, sustained ROSC at 23%, 24-h survival at 7%, and 1- and 3-month survival at 4.6%. No difference was determined in terms of ER stress markers between patients with and without ROSC or sustained ROSC. Only PERK levels were higher in surviving patients than non-surviving subjects in terms of 24-h survival (p = 0.01). Otherwise, no stress markers differed between surviving and non-surviving patients at any survival time point.
CONCLUSIONS: ER stress markers are of no value in determining establishment of ROSC or sustained ROSC, success of CPR, or survival. Only PERK levels may be valuable in terms of 24-h survival.

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