tetano
Editor, Senior Moderator
J Med Virol
. 2024 Jan;96(1):e29389.
doi: 10.1002/jmv.29389. SuPAR, biomarkers of inflammation, and severe outcomes in patients hospitalized for COVID-19: The International Study of Inflammation in COVID-19
Alexi Vasbinder[SUP] 1 [/SUP], Kishan Padalia[SUP] 2 [/SUP], Ian Pizzo[SUP] 1 [/SUP], Kristen Machado[SUP] 1 [/SUP], Tonimarie Catalan[SUP] 1 [/SUP], Feriel Presswalla[SUP] 1 [/SUP], Elizabeth Anderson[SUP] 1 [/SUP], Anis Ismail[SUP] 1 [/SUP], Christina Hutten[SUP] 1 [/SUP], Yiyuan Huang[SUP] 3 [/SUP], Pennelope Blakely[SUP] 1 [/SUP], Tariq U Azam[SUP] 1 [/SUP], Hanna Berlin[SUP] 2 [/SUP], Rafey Feroze[SUP] 2 [/SUP], Christopher Launius[SUP] 1 [/SUP], Chelsea Meloche[SUP] 2 [/SUP], Erinleigh Michaud[SUP] 2 [/SUP], Patrick O'Hayer[SUP] 2 [/SUP], Michael Pan[SUP] 2 [/SUP], Husam R Shadid[SUP] 2 [/SUP], Line Jee Hartmann Rasmussen[SUP] 4 [/SUP], Donald A Roberts[SUP] 5 [/SUP], Lili Zhao[SUP] 3 [/SUP], Mousumi Banerjee[SUP] 3 [/SUP], Venkatesh Murthy[SUP] 1 [/SUP], Sven H Loosen[SUP] 6 [/SUP], Athanasios Chalkias[SUP] 7 8 [/SUP], Frank Tacke[SUP] 9 [/SUP], Jochen Reiser[SUP] 10 [/SUP], Evangelos J Giamarellos-Bourboulis[SUP] 11 [/SUP], Jesper Eugen-Olsen[SUP] 4 [/SUP], Rodica Pop-Busui[SUP] 12 [/SUP], Salim S Hayek[SUP] 1 [/SUP]; ISIC investigators
Affiliations
Severe coronavirus disease 2019 (COVID-19) is a hyperinflammatory syndrome. The biomarkers of inflammation best suited to triage patients with COVID-19 are unknown. We conducted a prospective multicenter observational study of adult patients hospitalized specifically for COVID-19 from February 1, 2020 to October 19, 2022. Biomarkers measured included soluble urokinase plasminogen activator receptor (suPAR), C-reactive protein, interleukin-6, procalcitonin, ferritin, and D-dimer. In-hospital outcomes examined include death and the need for mechanical ventilation. Patients admitted in the United States (US, n = 1962) were used to compute area under the curves (AUCs) and identify biomarker cutoffs. The combined European cohorts (n = 1137) were used to validate the biomarker cutoffs. In the US cohort, 356 patients met the composite outcome of death (n = 197) or need for mechanical ventilation (n = 290). SuPAR was the most important predictor of the composite outcome and had the highest AUC (0.712) followed by CRP (0.642), ferritin (0.619), IL-6 (0.614), D-dimer (0.606), and lastly procalcitonin (0.596). Inclusion of other biomarkers did not improve discrimination. A suPAR cutoff of 4.0 ng/mL demonstrated a sensitivity of 95.4% (95% CI: 92.4%-98.0%) and negative predictive value (NPV) of 92.5% (95% CI: 87.5%-96.9%) for the composite outcome. Patients with suPAR < 4.0 ng/mL comprised 10.6% of the cohort and had a 0.8% probability of the composite outcome. Applying this cutoff to the validation cohort yielded a sensitivity of 93.8% (90.4%-96.7%) and NPV of 95.5% (93.1%-97.8%) for the composite outcome. Among commonly measured biomarkers, suPAR offered stronger discriminatory ability and may be useful in triaging low-risk patients with COVID-19.
Keywords: C-reactive protein; CRP; SARS-CoV-2; SuPAR; infection; interleukin-6; risk prediction; soluble urokinase plasminogen activator receptor; triage.
. 2024 Jan;96(1):e29389.
doi: 10.1002/jmv.29389. SuPAR, biomarkers of inflammation, and severe outcomes in patients hospitalized for COVID-19: The International Study of Inflammation in COVID-19
Alexi Vasbinder[SUP] 1 [/SUP], Kishan Padalia[SUP] 2 [/SUP], Ian Pizzo[SUP] 1 [/SUP], Kristen Machado[SUP] 1 [/SUP], Tonimarie Catalan[SUP] 1 [/SUP], Feriel Presswalla[SUP] 1 [/SUP], Elizabeth Anderson[SUP] 1 [/SUP], Anis Ismail[SUP] 1 [/SUP], Christina Hutten[SUP] 1 [/SUP], Yiyuan Huang[SUP] 3 [/SUP], Pennelope Blakely[SUP] 1 [/SUP], Tariq U Azam[SUP] 1 [/SUP], Hanna Berlin[SUP] 2 [/SUP], Rafey Feroze[SUP] 2 [/SUP], Christopher Launius[SUP] 1 [/SUP], Chelsea Meloche[SUP] 2 [/SUP], Erinleigh Michaud[SUP] 2 [/SUP], Patrick O'Hayer[SUP] 2 [/SUP], Michael Pan[SUP] 2 [/SUP], Husam R Shadid[SUP] 2 [/SUP], Line Jee Hartmann Rasmussen[SUP] 4 [/SUP], Donald A Roberts[SUP] 5 [/SUP], Lili Zhao[SUP] 3 [/SUP], Mousumi Banerjee[SUP] 3 [/SUP], Venkatesh Murthy[SUP] 1 [/SUP], Sven H Loosen[SUP] 6 [/SUP], Athanasios Chalkias[SUP] 7 8 [/SUP], Frank Tacke[SUP] 9 [/SUP], Jochen Reiser[SUP] 10 [/SUP], Evangelos J Giamarellos-Bourboulis[SUP] 11 [/SUP], Jesper Eugen-Olsen[SUP] 4 [/SUP], Rodica Pop-Busui[SUP] 12 [/SUP], Salim S Hayek[SUP] 1 [/SUP]; ISIC investigators
Affiliations
- PMID: 38235904
- DOI: 10.1002/jmv.29389
Severe coronavirus disease 2019 (COVID-19) is a hyperinflammatory syndrome. The biomarkers of inflammation best suited to triage patients with COVID-19 are unknown. We conducted a prospective multicenter observational study of adult patients hospitalized specifically for COVID-19 from February 1, 2020 to October 19, 2022. Biomarkers measured included soluble urokinase plasminogen activator receptor (suPAR), C-reactive protein, interleukin-6, procalcitonin, ferritin, and D-dimer. In-hospital outcomes examined include death and the need for mechanical ventilation. Patients admitted in the United States (US, n = 1962) were used to compute area under the curves (AUCs) and identify biomarker cutoffs. The combined European cohorts (n = 1137) were used to validate the biomarker cutoffs. In the US cohort, 356 patients met the composite outcome of death (n = 197) or need for mechanical ventilation (n = 290). SuPAR was the most important predictor of the composite outcome and had the highest AUC (0.712) followed by CRP (0.642), ferritin (0.619), IL-6 (0.614), D-dimer (0.606), and lastly procalcitonin (0.596). Inclusion of other biomarkers did not improve discrimination. A suPAR cutoff of 4.0 ng/mL demonstrated a sensitivity of 95.4% (95% CI: 92.4%-98.0%) and negative predictive value (NPV) of 92.5% (95% CI: 87.5%-96.9%) for the composite outcome. Patients with suPAR < 4.0 ng/mL comprised 10.6% of the cohort and had a 0.8% probability of the composite outcome. Applying this cutoff to the validation cohort yielded a sensitivity of 93.8% (90.4%-96.7%) and NPV of 95.5% (93.1%-97.8%) for the composite outcome. Among commonly measured biomarkers, suPAR offered stronger discriminatory ability and may be useful in triaging low-risk patients with COVID-19.
Keywords: C-reactive protein; CRP; SARS-CoV-2; SuPAR; infection; interleukin-6; risk prediction; soluble urokinase plasminogen activator receptor; triage.