Slovak scientists link enzyme to the risk of death from COVID-19

Bratislava, 7. September 2023: Research into COVID-19 continues even after the pandemic is over, delivering new knowledge that could be used in future pandemics and applied to other, non-infectious diseases. The link between a severe form of COVID-19 and the activity of the butyrylcholinesterase enzyme in human blood was discovered by a research team from the Faculty of Pharmacy of Comenius University Bratislava, led by pharmacologist Anna Paul Hrabovská, in cooperation with experts from the Trnava University Hospital. Their study was recently published in Chemico-Biological Interactions, a prestigious toxicology journal.

08. 09. 2023 09.34 hod.
By: CU External Relations Office

One worry during the pandemic was the uncertain prognosis of a Coronavirus infection. No sure-fire indicator was found that could predict whether the disease would have a severe course or even result in death, and doctors could not alert patients who might benefit from extra attention. Worldwide, researchers have been trying to discover risk factors correlated with a severe course of COVID-19. One of them turned out to be the plasma activity of butyrylcholinesterase. "It is an enzyme whose physiological role has not yet been described, and even healthy individuals sometimes exhibit no activity of this enzyme. The COVID-19 pandemic showed that these individuals were more susceptible to a SARS-CoV-2 infection, and a high mortality rate was encountered in the community of people in whom this enzyme is inactive,” explains lead researcher Anna Paul Hrabovská from the Faculty of Pharmacy of Comenius University.

A Slovak study, conducted between October 2021 and May 2022 on 148 hospitalized patients showed that a decrease in plasma butyrylcholinesterase activity was associated with a negative prognosis of COVID-19, even when the patient's condition improved temporarily. On the other hand, an increase in its activity can predict an improvement of the patient's health. Enzyme activity provides this valuable information regardless of the patient's age, gender or body mass.

However, the enzyme studied by the Slovak team could likely reveal much more. Butyrylcholinesterase activity is being studied intensively because it may be a valuable prognostic indicator for other diseases than COVID-19. In a study which recently appeared in the journal eBioMedicine, published by Lancet, butyrylcholinesterase activity was identified as a possible biomarker for sudden infant death syndrome. The activity of this enzyme has also been found to decrease in the elderly and during various fatal diseases. "I assume that butyrylcholinesterase activity reflects the overall clinical state of the organism and its prognosis, independently of the actual pathology," explains researcher Anna Paul Hrabovská. Therefore, she is designing a study which will focus on patients affected by other serious pathologies. She and her research team work on projects that might help to improve the identification of patients who require more intensive medical care, leading to a possible rapid improvement of their condition.