Mester Patricia, Keller Dennis, Kunst Claudia, Schmid Stephan, Krautbauer Sabrina, Müller Martina, Buechler Christa, Pavel Vlad
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, Immunology, and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany.
Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, 93053 Regensburg, Germany.
Viruses. 2025 Feb 28;17(3):357. doi: 10.3390/v17030357.
Presepsin, a cleaved peptide of soluble CD14, may become a promising biomarker for assessing disease severity and mortality in coronavirus disease 2019 (COVID-19). Patients with severe COVID-19 frequently develop bacterial and fungal superinfections, as well as herpes simplex virus-1 (HSV-1) reactivation, which may exacerbate disease progression. This study aimed to evaluate the impact of concomitant infections on serum presepsin levels. Serum presepsin levels were measured using an enzyme-linked immunosorbent assay (ELISA) in 63 patients with moderate COVID-19, 60 patients with severe disease, and 49 healthy controls. Correlations with procalcitonin and the presence of superinfections or HSV-1 reactivation were assessed. Consistent with previous studies, serum presepsin levels were the highest in patients with severe COVID-19 ( = 0.002 compared to patients with moderate disease). Within this group, non-survivors exhibited significantly elevated presepsin levels ( = 0.027). A positive correlation between presepsin and procalcitonin was observed in both moderate and severe COVID-19 cases. Patients with bacterial or fungal superinfections showed presepsin levels comparable to those without secondary infections. However, presepsin levels were markedly elevated in patients with HSV-1 reactivation ( = 0.002). After excluding patients with HSV-1 reactivation, presepsin levels no longer differed between moderate and severe COVID-19 cases, though they remained higher than in healthy controls ( < 0.001 for both comparisons). In conclusion, these findings suggest that elevated serum presepsin levels in severe COVID-19 are primarily driven by HSV-1 reactivation rather than bacterial or fungal superinfections.
可溶性CD14的裂解肽 presepsin 可能成为评估2019冠状病毒病（COVID-19）疾病严重程度和死亡率的一种有前景的生物标志物。重症COVID-19患者经常发生细菌和真菌二重感染，以及单纯疱疹病毒1型（HSV-1）再激活，这可能会加剧疾病进展。本研究旨在评估合并感染对血清 presepsin 水平的影响。采用酶联免疫吸附测定（ELISA）法测量了63例中度COVID-19患者、60例重症患者和49名健康对照者的血清 presepsin 水平。评估了其与降钙素原以及二重感染或HSV-1再激活情况的相关性。与先前研究一致，重症COVID-19患者的血清 presepsin 水平最高（与中度疾病患者相比，P = 0.002）。在该组中，非幸存者的 presepsin 水平显著升高（P = 0.027）。在中度和重度COVID-19病例中均观察到 presepsin 与降钙素原之间呈正相关。发生细菌或真菌二重感染的患者的 presepsin 水平与未发生继发感染的患者相当。然而，HSV-1再激活患者的 presepsin 水平显著升高（P = 0.002）。排除HSV-1再激活患者后，中度和重度COVID-19病例之间的 presepsin 水平不再有差异，尽管仍高于健康对照者（两项比较均P < 0.001）。总之，这些发现表明，重症COVID-19患者血清 presepsin 水平升高主要由HSV-1再激活而非细菌或真菌二重感染所致。
