Espeter Florian, Künne David, Garczarek Lena, Kuhlmann Henning, Skarabis Annabell, Zivkovic Aleksandar R, Brenner Thorsten, Schmidt Karsten
Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany.
Department of Anesthesiology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Diagnostics (Basel). 2022 Sep 3;12(9):2150. doi: 10.3390/diagnostics12092150.
A biomarker for risk stratification and disease severity assessment in SARS-CoV-2 infections has not yet been established. Point of care testing (POCT) of butyrylcholinesterase (BChE) enables early detection of systemic inflammatory responses and correlates with disease severity in sepsis and burns. In acute care or resource-limited settings, POCT facilitates rapid clinical decision making, a particularly beneficial aspect in the management of pandemic situations. In this prospective observational study, POCT-measured BChE activity was assessed in 52 critically ill COVID-19 patients within 24 h of ICU admission and on the third and seventh day after ICU admission. Forty (77%) of these patients required venovenous extracorporeal membrane oxygenation (vvECMO). In critically ill COVID-19 patients, BChE activity is significantly decreased compared with healthy subjects, but also compared with other inflammatory conditions such as sepsis, burns, or trauma. POCT BChE activity reflects the severity of organ dysfunction and allows prediction of 28-day mortality in critically ill COVID-19 patients. Implementing early POCT BChE measurement could facilitate risk stratification and support admission and transfer decisions in resource-limited settings.
目前尚未建立用于评估新型冠状病毒2（SARS-CoV-2）感染风险分层和疾病严重程度的生物标志物。对丁酰胆碱酯酶（BChE）进行即时检测（POCT）能够早期发现全身炎症反应，且与脓毒症和烧伤患者的疾病严重程度相关。在急性护理或资源有限的环境中，POCT有助于快速做出临床决策，这在大流行情况的管理中是一个特别有益的方面。在这项前瞻性观察研究中，对52例危重症新型冠状病毒肺炎（COVID-19）患者在重症监护病房（ICU）入院后24小时内以及ICU入院后第三天和第七天进行了POCT测量的BChE活性评估。其中40例（77%）患者需要静脉-静脉体外膜肺氧合（vvECMO）。在危重症COVID-19患者中，与健康受试者相比，BChE活性显著降低，与脓毒症、烧伤或创伤等其他炎症性疾病相比也是如此。POCT检测的BChE活性反映了器官功能障碍的严重程度，并能够预测危重症COVID-19患者的28天死亡率。实施早期POCT检测BChE可以促进风险分层，并为资源有限环境中的入院和转运决策提供支持。
