Τίτλος:
Integration of heparin-binding protein and interleukin-6 in the early prediction of respiratory failure and mortality in pneumonia by SARS-CoV-2 (COVID-19)
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Recent publications on the probable role of heparin-binding protein (HBP) as a biomarker in sepsis prompted us to investigate its diagnostic and prognostic performance in severe COVID-19. HBP and IL-6 were measured by immunoassays at admission and on day 7 in 178 patients with pneumonia by SARS-CoV-2. Patients were classified into non-sepsis and sepsis as per the Sepsis-3 definitions and were followed up for the development of severe respiratory failure (SRF) and for outcome. Results were confirmed by multivariate analyses. HBP was significantly higher in patients classified as having sepsis and was negatively associated with the oxygenation ratio and positively associated with creatinine and lactate. Logistic regression analysis evidenced admission HBP more than 18 ng/ml and IL-6 more than 30 pg/ml as independent risk factors for the development of SRP. Their integration prognosticated SRF with respective sensitivity, specificity, positive predictive value, and negative predictive 59.1%, 96.3%, 83.9%, and 87.8%. Cox regression analysis evidenced admission HBP more than 35 ng/ml and IL-6 more than 30 pg/ml as independent risk factors for 28-day mortality. Their integration prognosticated 28-day mortality with respective sensitivity, specificity, positive predictive value, and negative predictive value 69.2%, 92.7%, 42.9%, and 97.5%. HBP remained unchanged over-time course. A prediction score of the disposition of patients with COVID-19 is proposed taking into consideration admission levels of IL-6 and HBP. Using different cut-offs, the score may predict the likelihood for SRF and for 28-day outcome. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
Συγγραφείς:
Saridaki, M.
Metallidis, S.
Grigoropoulou, S.
Vrentzos, E.
Lada, M.
Argyraki, K.
Tsachouridou, O.
Georgiadou, A.
Vasishta, A.
Giamarellos-Bourboulis, E.J.
Περιοδικό:
European Journal of Clinical Microbiology and Infectious Diseases
Εκδότης:
Springer Science and Business Media Deutschland GmbH
Λέξεις-κλειδιά:
creatinine; heparin binding protein; interleukin 6; lactic acid; antimicrobial cationic peptide; AZU1 protein, human; biological marker; IL6 protein, human; interleukin 6; plasma protein, adult; Article; clinical outcome; controlled study; coronavirus disease 2019; creatinine blood level; diagnostic test accuracy study; female; follow up; hospital admission; human; immunoassay; lactate blood level; major clinical study; male; mortality; mortality rate; nonhuman; oxygenation; predictive value; prognosis; respiratory failure; sensitivity and specificity; Severe acute respiratory syndrome coronavirus 2; blood; isolation and purification; mortality; pathophysiology; prognosis; respiratory failure; sepsis; virus pneumonia, Adult; Antimicrobial Cationic Peptides; Biomarkers; Blood Proteins; COVID-19; Female; Humans; Interleukin-6; Male; Pneumonia, Viral; Predictive Value of Tests; Prognosis; Respiratory Insufficiency; SARS-CoV-2; Sepsis
DOI:
10.1007/s10096-020-04145-7
