Abdelhakam Dina A, Badr Fatma Mohammed, Abd El Monem Teama Mohammed, Bahig Elmihi Nouran M, El-Mohamdy Marwa Adham
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
Biomed Rep. 2022 Feb;16(2):13. doi: 10.3892/br.2021.1496. Epub 2021 Dec 21.
In view of the rapid spread of COVID-19 and the high mortality rate of severe cases, reliable risk stratifying indicators of prognosis are necessary to decrease morbidity and mortality. The aim of the present study was to evaluate the value of serum amyloid A (SAA) and carcinoembryonic antigen (CEA) as prognostic biomarkers in comparison to other predictors, including C-reactive protein (CRP) and ferritin levels. This study included 124 patients diagnosed with COVID-19, and they were assigned to one of two groups: Mild and severe, based on the severity of the infection. Radiological and laboratory investigations were performed, including evaluation of CRP, ferritin, D-Dimer, SAA and CEA levels. Significantly higher levels of CRP, ferritin, D-Dimer, SAA and CEA were observed in severe cases. SAA was significantly correlated with CRP (r=0.422, P<0.001), ferritin (r=0.574, P<0.001), CEA (r=0.514, P<0.001) and computed tomography severity score (CT-SS; r=0.691, P<0.001). CEA was correlated with CRP (r=0.441, P<0.001), ferritin (r=0.349, P<0.001) and CT-SS (r=0.374, P<0.001). Receiver operator characteristic (ROC) curves for performance of SAA, CEA, ferritin, CRP and SAA showed the highest AUC value of 0.928, with a specificity of 93.1%, and a sensitivity of 98.5% at a cut-off of 16 mg/l. The multi-ROC curve for SAA and ferritin showed 100% specificity, 100% sensitivity and 100% efficiency, with an AUC of 1.000. Thus, combining SAA and ferritin may have guiding significance for predicting COVID-19 severity. SAA alone showed the highest prognostic significance. Both SAA and CEA were positively correlated with the CT-SS. Early monitoring of these laboratory markers may thus provide significant input for halting disease progression and reducing mortality rates.
鉴于新型冠状病毒肺炎(COVID-19)的迅速传播以及重症病例的高死亡率,为降低发病率和死亡率,可靠的预后风险分层指标必不可少。本研究的目的是评估血清淀粉样蛋白A(SAA)和癌胚抗原(CEA)作为预后生物标志物的价值,并与其他预测指标进行比较,包括C反应蛋白(CRP)和铁蛋白水平。本研究纳入了124例确诊为COVID-19的患者,根据感染严重程度将他们分为两组:轻症组和重症组。进行了影像学和实验室检查,包括评估CRP、铁蛋白、D-二聚体、SAA和CEA水平。重症病例中CRP、铁蛋白、D-二聚体、SAA和CEA水平显著更高。SAA与CRP(r=0.422,P<0.001)、铁蛋白(r=0.574,P<0.001)、CEA(r=0.514,P<0.001)以及计算机断层扫描严重程度评分(CT-SS;r=0.691,P<0.001)显著相关。CEA与CRP(r=0.441,P<0.001)、铁蛋白(r=0.349,P<0.001)和CT-SS(r=0.374,P<0.001)相关。SAA、CEA、铁蛋白、CRP和SAA的受试者工作特征(ROC)曲线显示,曲线下面积(AUC)最高值为0.928,在截断值为16 mg/l时,特异性为93.1%,敏感性为98.5%。SAA和铁蛋白的多ROC曲线显示特异性为100%、敏感性为100%、效率为100%,AUC为1.000。因此,联合SAA和铁蛋白可能对预测COVID-19严重程度具有指导意义。单独SAA显示出最高的预后意义。SAA和CEA均与CT-SS呈正相关。因此,早期监测这些实验室指标可能为阻止疾病进展和降低死亡率提供重要依据。