血清淀粉样蛋白 P 物质 3（PTX-3）作为预测 COVID-19 住院患者死亡的潜在生物标志物。

Pentraxin-3 (PTX-3) as a potential biomarker for predicting death in hospitalized patients with COVID-19.

机构信息

Postgraduate Program in Biosciences, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba. sn, Petrolina, Pernambuco, Brazil.

College of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Pernambuco, Brazil.

出版信息

Virol J. 2024 Sep 27;21(1):233. doi: 10.1186/s12985-024-02501-z.

DOI:10.1186/s12985-024-02501-z

PMID:39334467

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11428883/

Abstract

BACKGROUND

Pentraxin 3 (PTX3) is an acute-phase protein that belongs to the pentraxin family, which plays an important role in the body's defense against pathogens. PTX3 levels have been associated with inflammatory processes, and it is a possible biomarker for the diagnosis and prognosis of different infectious diseases, including COVID-19. The objective of this study was to analyze the potential of PTX3 as a plasma biomarker for predicting death in patients hospitalized with COVID-19.

METHODS

The study included a total of 312 patients with COVID-19, admitted from July 2020 to August 2021 to hospital ward and intensive care unit beds at two hospitals in the Northeast Region of Brazil. PTX3 was measured using ELISA in samples collected within 24 h after hospital admission. Maximally selected rank statistics were used to determine the PTX3 cutoff point that best distinguished patients who died from those who survived. A receiver operating characteristic (ROC) curve was used to determine the performance of the biomarker. Survival analysis was performed using a Kaplan-Meier curve, and a Cox regression model was used to determine predictors associated with death.

RESULTS

Of the 312 patients included in the study, 233 recovered and 79 died. Patients who died had higher PTX3 levels at the time of admission, when compared to those who recovered (median: 52.84 versus 10.79 ng/mL; p < 0.001). PTX3 showed area under the ROC (AUC) = 0.834, higher than other markers used in clinical practice, such as C-reactive protein (AUC = 0.72) and D-dimer (AUC = 0.77). Furthermore, according to the Kaplan-Meier survival curve, patients with PTX3 concentrations above the cutoff point (27.3 ng/mL) had a lower survival rate (p = 0.014). In multivariate Cox regression, PTX3 > 27.3 ng/mL was an important predictor of death, regardless of other confounding factors (hazard ratio = 1.79; p = 0.027).

CONCLUSION

PTX3 can be considered as a potential biomarker for predicting death in patients hospitalized with COVID-19.

摘要

背景

Pentraxin 3（PTX3）是一种属于 pentraxin 家族的急性期蛋白，在机体防御病原体中发挥重要作用。PTX3 水平与炎症过程有关，并且可能是诊断和预测不同传染病（包括 COVID-19）的生物标志物。本研究旨在分析 PTX3 作为预测 COVID-19 住院患者死亡的血浆生物标志物的潜力。

方法

本研究共纳入 2020 年 7 月至 2021 年 8 月期间来自巴西东北部两家医院住院病房和重症监护病房的 312 例 COVID-19 患者。使用 ELISA 法在患者入院后 24 小时内采集的样本中测量 PTX3。采用最大选择秩统计法确定区分死亡和存活患者的最佳 PTX3 截断值。使用受试者工作特征（ROC）曲线确定生物标志物的性能。使用 Kaplan-Meier 曲线进行生存分析，并使用 Cox 回归模型确定与死亡相关的预测因素。

结果

本研究共纳入 312 例患者，其中 233 例患者康复，79 例患者死亡。与康复患者相比，死亡患者入院时的 PTX3 水平更高（中位数：52.84 与 10.79 ng/mL；p<0.001）。PTX3 的 ROC 曲线下面积（AUC）为 0.834，高于临床实践中使用的其他标志物，如 C 反应蛋白（AUC=0.72）和 D-二聚体（AUC=0.77）。此外，根据 Kaplan-Meier 生存曲线，PTX3 浓度高于截断值（27.3 ng/mL）的患者生存率较低（p=0.014）。在多变量 Cox 回归中，PTX3>27.3 ng/mL 是死亡的重要预测因素，与其他混杂因素无关（危险比=1.79；p=0.027）。