Sehgal Tushar, Anand Ambika, Vijayabupathy Gowtham, Khan Maroof
Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Biostatistics, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Cureus. 2024 Nov 25;16(11):e74438. doi: 10.7759/cureus.74438. eCollection 2024 Nov.
Introduction Efficient and practical healthcare based on prognostic indicators can reduce morbidity and mortality in hospitalized COVID-19 patients. Soluble urokinase plasminogen activator receptor (suPAR) predicts clinical outcomes and respiratory failure in SARS-CoV-2 patients, but additional research is needed. Among other characteristics, we aimed to evaluate the predictive value of suPAR in COVID-19 patients. Methods This observational study was conducted at the All India Institute of Medical Sciences in New Delhi between January and April 2022. Patients within the age range from 18 to 85 years with mild, moderate, or severe COVID-19 infections were included in the study. Twenty-one patients (group 1) had positive RT-PCR throat and nasal swabs. Nine patients (group 2) with fever but without COVID-19 were recruited as controls. Ninety patient samples were tested for suPAR on days 1, 5, and 10 utilizing suPARnostic AUTO Flex ELISA kits (ViroGates, Denmark). Results The median age was 59 years in both groups. COVID-19 was mild in six patients (29%), moderate in seven patients (33%), and severe in eight patients (38%). At a median follow-up of 10 days, 8 out of 21 patients (38%) in group 1 died, while none in group 2 died. Patients' median suPAR levels were 4.35 ng/ml on day 1, 4.68 ng/ml on day 5, and 4.37 ng/ml on day 10. In the control group, suPAR levels were 1.6 ng/ml on day 1, 1.7 ng/ml on day 5, and 2.02 ng/ml on day 10. The suPAR levels were statistically significant on day 1 (p = 0.004), day 5 (p = 0.04), and day 10 (p = 0.007) between the patient and the control groups. Conclusion Patients who died had higher suPAR levels on days 1 (p = 0.007), 5 (p = 0.01), and 10 (p = 0.03) than survivors. The suPAR cut-off ≥ 3.64 (AUC = 0.82) predicts mortality with 88% sensitivity and 73% specificity.
基于预后指标的高效实用医疗保健可降低新冠肺炎住院患者的发病率和死亡率。可溶性尿激酶型纤溶酶原激活物受体（suPAR）可预测SARS-CoV-2患者的临床结局和呼吸衰竭，但仍需更多研究。在其他特征中，我们旨在评估suPAR在新冠肺炎患者中的预测价值。
本观察性研究于2022年1月至4月在新德里全印度医学科学研究所进行。年龄在18至85岁之间、患有轻度、中度或重度新冠肺炎感染的患者被纳入研究。21例患者（第1组）咽拭子和鼻拭子RT-PCR检测呈阳性。招募9例发热但未感染新冠肺炎的患者（第2组）作为对照。使用suPARnostic AUTO Flex ELISA试剂盒（丹麦ViroGates公司）在第1天、第5天和第10天对90份患者样本进行suPAR检测。
两组患者的中位年龄均为59岁。6例患者（29%）为轻度新冠肺炎，7例患者（33%）为中度，8例患者（38%）为重度。中位随访10天，第1组21例患者中有8例（38%）死亡，而第2组无死亡病例。患者的suPAR中位水平在第1天为4.35 ng/ml，第5天为4.68 ng/ml，第10天为4.37 ng/ml。对照组第1天suPAR水平为1.6 ng/ml，第5天为1.7 ng/ml，第10天为2.02 ng/ml。患者组和对照组在第1天（p = 0.004）、第5天（p = 0.04）和第10天（p = 0.007）的suPAR水平差异具有统计学意义。
死亡患者在第1天（p = 0.007）、第5天（p = 0.01）和第10天（p = 0.03）的suPAR水平高于存活患者。suPAR临界值≥3.64（AUC = 0.82）预测死亡率的灵敏度为88%，特异度为73%。
