Biology Department, Foch Hospital, 92150 Suresnes, France.
Radiology Department, Foch Hospital, 92150 Suresnes, France.
Viruses. 2023 Feb 2;15(2):419. doi: 10.3390/v15020419.
SeptiCyte RAPID is a gene expression assay measuring the relative expression levels of host response genes PLA2G7 and PLAC8, indicative of a dysregulated immune response during sepsis. As severe forms of COVID-19 may be considered viral sepsis, we evaluated SeptiCyte RAPID in a series of 94 patients admitted to Foch Hospital (Suresnes, France) with proven SARS-CoV-2 infection. EDTA blood was collected in the emergency department (ED) in 67 cases, in the intensive care unit (ICU) in 23 cases and in conventional units in 4 cases. SeptiScore (0-15 scale) increased with COVID-19 severity. Patients in ICU had the highest SeptiScores, producing values comparable to 8 patients with culture-confirmed bacterial sepsis. Receiver operating characteristic (ROC) curve analysis had an area under the curve (AUC) of 0.81 for discriminating patients requiring ICU admission from patients who were immediately discharged or from patients requiring hospitalization in conventional units. SeptiScores increased with the extent of the lung injury. For 68 patients, a chest computed tomography (CT) scan was performed within 24 h of COVID-19 diagnosis. SeptiScore >7 suggested lung injury ≥50% (AUC = 0.86). SeptiCyte RAPID was compared to other biomarkers for discriminating Critical + Severe COVID-19 in ICU, versus Moderate + Mild COVID-19 not in ICU. The mean AUC for SeptiCyte RAPID was superior to that of any individual biomarker or combination thereof. In contrast to C-reactive protein (CRP), correlation of SeptiScore with lung injury was not impacted by treatment with anti-inflammatory agents. SeptiCyte RAPID can be a useful tool to identify patients with severe forms of COVID-19 in ED, as well as during follow-up.
SepsiCyte RAPID 是一种基因表达检测，用于测量宿主反应基因 PLA2G7 和 PLAC8 的相对表达水平，这表明在脓毒症期间免疫反应失调。由于严重形式的 COVID-19 可能被认为是病毒性脓毒症，我们在法国苏雷斯讷的福煦医院（Foch Hospital）对 94 例确诊 SARS-CoV-2 感染的患者进行了 SepsiCyte RAPID 评估。在急诊室（ED）采集了 67 例患者的 EDTA 血样，在重症监护病房（ICU）采集了 23 例患者的 EDTA 血样，在常规病房采集了 4 例患者的 EDTA 血样。SepiScore（0-15 分）随 COVID-19 严重程度而增加。在 ICU 的患者的 SepiScores 最高，其值与 8 例经培养确诊的细菌性脓毒症患者的数值相当。接受者操作特征（ROC）曲线分析区分需要 ICU 入住的患者与立即出院的患者或需要入住常规病房的患者的曲线下面积（AUC）为 0.81。SepiScores 随肺损伤程度的增加而增加。对于 68 例患者，在 COVID-19 诊断后 24 小时内进行了胸部计算机断层扫描（CT）。SepiScore >7 提示肺损伤≥50%（AUC = 0.86）。SepsiCyte RAPID 与其他生物标志物进行了比较，以区分 ICU 中的危重症+重症 COVID-19 与非 ICU 中的轻症+中度 COVID-19。SepsiCyte RAPID 的平均 AUC 优于任何单一生物标志物或其组合。与 C 反应蛋白（CRP）不同，SepiScore 与肺损伤的相关性不受抗炎药物治疗的影响。SepsiCyte RAPID 可以成为在 ED 识别 COVID-19 严重形式的有用工具，也可以在随访期间使用。
