Vassiliou Alice G, Zacharis Alexandros, Vrettou Charikleia S, Keskinidou Chrysi, Jahaj Edison, Mastora Zafeiria, Orfanos Stylianos E, Dimopoulou Ioanna, Kotanidou Anastasia
First Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Evangelismos Hospital, 106 76 Athens, Greece.
Diagnostics (Basel). 2022 May 18;12(5):1261. doi: 10.3390/diagnostics12051261.
In the last years, biomarkers of infection, such as the soluble urokinase plasminogen activator receptor (suPAR), have been extensively studied as potential diagnostic and prognostic biomarkers in the intensive care unit (ICU). In this study, we investigated whether this biomarker can be used in COVID-19 and non-COVID-19 septic patients for mortality prediction. Serum suPAR levels were measured in 79 non-COVID-19 critically ill patients upon sepsis (within 6 h), and on admission in 95 COVID-19 patients (66 critical and 29 moderate/severe). The non-COVID-19 septic patients were matched for age, sex, and disease severity, while the site of infection was the respiratory system. On admission, COVID-19 patients presented with higher suPAR levels, compared to non-COVID-19 septic patients (p < 0.01). More importantly, suPAR measured upon sepsis could not differentiate survivors from non-survivors (p > 0.05), as opposed to suPAR measured on admission in COVID-19 survivors and non-survivors (p < 0.0001). By the generated ROC curve, the prognostic value of suPAR in COVID-19 was 0.81, at a cut-off value of 6.3 ng/mL (p < 0.0001). suPAR measured early (within 24 h) after hospital admission seems like a specific and sensitive mortality risk predictor in COVID-19 patients. On the contrary, suPAR measured at sepsis diagnosis in non-COVID-19 critically ill patients, does not seem to be a prognostic factor of mortality.
在过去几年中，感染生物标志物，如可溶性尿激酶型纤溶酶原激活物受体（suPAR），已作为重症监护病房（ICU）潜在的诊断和预后生物标志物得到广泛研究。在本研究中，我们调查了这种生物标志物是否可用于预测新冠肺炎和非新冠肺炎脓毒症患者的死亡率。对79例非新冠肺炎重症脓毒症患者（在脓毒症发生后6小时内）以及95例新冠肺炎患者（66例危重症和29例中重症）入院时的血清suPAR水平进行了测量。非新冠肺炎脓毒症患者在年龄、性别和疾病严重程度方面进行了匹配，感染部位均为呼吸系统。入院时，与非新冠肺炎脓毒症患者相比，新冠肺炎患者的suPAR水平更高（p<0.01）。更重要的是，脓毒症发生时测量的suPAR无法区分幸存者和非幸存者（p>0.05），而新冠肺炎幸存者和非幸存者入院时测量的suPAR则有显著差异（p<0.0001）。通过生成的ROC曲线，suPAR在新冠肺炎中的预后价值为0.81，截断值为6.3 ng/mL（p<0.0001）。入院后早期（24小时内）测量的suPAR似乎是新冠肺炎患者特异性和敏感性较高的死亡风险预测指标。相反，在非新冠肺炎重症患者脓毒症诊断时测量的suPAR似乎不是死亡率的预后因素。
