tetano
Editor, Senior Moderator
Clin Chim Acta
. 2023 Oct 21:117586.
doi: 10.1016/j.cca.2023.117586. Online ahead of print. Plasma SARS-CoV-2 N antigen is a powerful molecular marker for early detection of severe COVID-19 in patients and monitoring disease progression
Xiaoyan Teng[SUP] 1 [/SUP], Liuping Hu[SUP] 1 [/SUP], Jiazhen Shen[SUP] 2 [/SUP], Jiudong Hu[SUP] 3 [/SUP], Xiaoyan Wu[SUP] 4 [/SUP], Yuzhen Du[SUP] 5 [/SUP]
Affiliations
Background and aims: Clear and effective indicators for early detection of severe coronavirus disease 2019 (COVID-19) are insufficient. We investigated the clinical value of the plasma SARS-CoV-2 N antigen (plasma N antigen) for severe COVID-19 early identification and disease progression monitoring.
Materials and methods: A cross-sectional study compared the diagnostic value of plasma N antigen levels detected within two days after hospital admission in 957 patients with COVID-19 during the BA2.2 outbreak in Shanghai (April 6-June 15, 2022). A follow-up study analyzed the plasma N antigen prognostic value in 274 non-severe patients, and a longitudinal study evaluated its continuous monitoring value in 16 patients with COVID-19 grade changes.
Results: Plasma N antigen concentrations were significantly higher in severely ill than in non-severely ill patients. The plasma N antigen was superior to nasopharyngeal nucleic acid CT values and established COVID-19 blood biomarkers in identifying severe COVID-19. Patients with high plasma N-antigen concentrations at initial admission were more prone to developing severe COVID-19. The changes in plasma N antigen concentrations were consistent with disease progression. Two logistic regression models, including and excluding plasma N antigen, were established, with model 1 (including plasma N antigen) (AUC = 0.971, 0.958-0.980) yielding a better diagnostic value for severe COVID-19 than Model 2 (plasma N antigen excluded).
Conclusion: The plasma N antigen is superior to nasopharyngeal nucleic acids and established COVID-19 blood biomarkers for severe COVID-19 early recognition and progression monitoring, enabling the most accurate patient triaging and efficient utilization of medical resources.
Keywords: Early recognition; Molecular marker; Plasma SARS-CoV-2N antigen; Progress monitoring; severe COVID-19.
. 2023 Oct 21:117586.
doi: 10.1016/j.cca.2023.117586. Online ahead of print. Plasma SARS-CoV-2 N antigen is a powerful molecular marker for early detection of severe COVID-19 in patients and monitoring disease progression
Xiaoyan Teng[SUP] 1 [/SUP], Liuping Hu[SUP] 1 [/SUP], Jiazhen Shen[SUP] 2 [/SUP], Jiudong Hu[SUP] 3 [/SUP], Xiaoyan Wu[SUP] 4 [/SUP], Yuzhen Du[SUP] 5 [/SUP]
Affiliations
- PMID: 37871761
- DOI: 10.1016/j.cca.2023.117586
Background and aims: Clear and effective indicators for early detection of severe coronavirus disease 2019 (COVID-19) are insufficient. We investigated the clinical value of the plasma SARS-CoV-2 N antigen (plasma N antigen) for severe COVID-19 early identification and disease progression monitoring.
Materials and methods: A cross-sectional study compared the diagnostic value of plasma N antigen levels detected within two days after hospital admission in 957 patients with COVID-19 during the BA2.2 outbreak in Shanghai (April 6-June 15, 2022). A follow-up study analyzed the plasma N antigen prognostic value in 274 non-severe patients, and a longitudinal study evaluated its continuous monitoring value in 16 patients with COVID-19 grade changes.
Results: Plasma N antigen concentrations were significantly higher in severely ill than in non-severely ill patients. The plasma N antigen was superior to nasopharyngeal nucleic acid CT values and established COVID-19 blood biomarkers in identifying severe COVID-19. Patients with high plasma N-antigen concentrations at initial admission were more prone to developing severe COVID-19. The changes in plasma N antigen concentrations were consistent with disease progression. Two logistic regression models, including and excluding plasma N antigen, were established, with model 1 (including plasma N antigen) (AUC = 0.971, 0.958-0.980) yielding a better diagnostic value for severe COVID-19 than Model 2 (plasma N antigen excluded).
Conclusion: The plasma N antigen is superior to nasopharyngeal nucleic acids and established COVID-19 blood biomarkers for severe COVID-19 early recognition and progression monitoring, enabling the most accurate patient triaging and efficient utilization of medical resources.
Keywords: Early recognition; Molecular marker; Plasma SARS-CoV-2N antigen; Progress monitoring; severe COVID-19.