Oulhaj Abderrahim, Alsuwaidi Ahmed R, Suliman Abubaker, Gasmelseed Huda, Khan Shaima, Alawi Shamma, Hukan Yaman, George Junu, Alshamsi Fayez, Sheikh Farrukh, Babiker Zahir Osman Eltahir, Prattes Juergen, Sourij Harald
Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Zayed Center for Health Sciences, United Arab Emirates University, United Arab Emirates.
Department of Paediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
Int J Infect Dis. 2021 Jun;107:188-194. doi: 10.1016/j.ijid.2021.04.026. Epub 2021 Apr 20.
To examine the association between plasma levels of the soluble urokinase plasminogen activator receptor (suPAR) and the incidence of severe complications of COVID-19.
403 RT-PCR-confirmed COVID-19 patients were recruited and prospectively followed-up at a major hospital in the United Arab Emirates. The primary endpoint was time from admission until the development of a composite outcome, including acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, or death from any cause. Patients discharged alive were considered as competing events to the primary outcome. Competing risk regression was used to quantify the association between suPAR and the incidence of the primary outcome.
6.2% of patients experienced ARDS or ICU admission, but none died. Taking into account competing risk, the incidence of the primary outcome was 11.5% (95% confidence interval [CI], 6.7-16.3) in patients with suPAR levels >3.91 ng/mL compared to 2.9% (95% CI, 0.4-5.5) in those with suPAR ≤3.91 ng/mL. Also, an increase by 1 ng/mL in baseline suPAR resulted in a 58% rise in the hazard of developing the primary outcome (hazard ratio 1.6, 95% CI, 1.2-2.1, p = 0.003).
suPAR has an excellent prognostic utility in predicting severe complications in hospitalised COVID-19 patients.
研究可溶性尿激酶型纤溶酶原激活物受体（suPAR）血浆水平与新型冠状病毒肺炎（COVID-19）严重并发症发生率之间的关联。
招募了403例经逆转录聚合酶链反应（RT-PCR）确诊的COVID-19患者，并在阿拉伯联合酋长国的一家大型医院进行前瞻性随访。主要终点是从入院到出现综合结局的时间，综合结局包括急性呼吸窘迫综合征（ARDS）、入住重症监护病房（ICU）或任何原因导致的死亡。存活出院的患者被视为主要结局的竞争事件。采用竞争风险回归分析来量化suPAR与主要结局发生率之间的关联。
6.2%的患者发生了ARDS或入住了ICU，但无人死亡。考虑到竞争风险，suPAR水平>3.91 ng/mL的患者中主要结局的发生率为11.5%（95%置信区间[CI]，6.7 - 16.3），而suPAR≤3.91 ng/mL的患者中该发生率为2.9%（95% CI，0.4 - 5.5）。此外，基线suPAR每增加1 ng/mL，发生主要结局的风险增加58%（风险比1.6，95% CI，1.2 - 2.1，p = 0.003）。
suPAR在预测住院COVID-19患者的严重并发症方面具有出色的预后价值。
