SuPAR, biomarkers of inflammation, and severe outcomes in patients hospitalized for COVID-19: The International Study of Inflammation in COVID-19.

SuPAR, biomarkers of inflammation, and severe outcomes in patients hospitalized for COVID-19: The International Study of Inflammation in COVID-19.

Publication date: Jan 01, 2024

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 

Concepts Keywords
Coronavirus Adult
February Biomarkers
Hospital Biomarkers
Hyperinflammatory C-reactive protein
COVID-19
CRP
Ferritins
Ferritins
Humans
infection
Inflammation
interleukin-6
Procalcitonin
Procalcitonin
Prognosis
Prospective Studies
risk prediction
SARS-CoV-2
SuPAR
triage

Semantics

Type Source Name
disease MESH inflammation
disease MESH COVID-19
disease MESH syndrome
disease MESH death
drug DRUGBANK Methionine
disease MESH infection
drug DRUGBANK Urokinase

Original Article

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