Presepsin in risk stratification of SARS-CoV-2 patients

Clin Chim Acta. 2020 Aug:507:161-163. doi: 10.1016/j.cca.2020.04.020. Epub 2020 Apr 22.

Abstract

Background: A severe form of pneumonia, is the leading complication of the respiratory Coronavirus disease 2019 (COVID-19), recently renamed SARS-CoV-2. Soluble cluster of differentiation (CD)14 subtype (sCD14-ST also termed presepsin PSP) is a regulatory factor that modulates immune responses by interacting with T and B cells, useful for early diagnosis, prognosis and risk stratification prediction.

Methods: In 75 consecutive patients suffering from COVID-19 microbiology proven infection, admitted to intensive care unit (ICU, n = 21, 28%) and/or in infectious disease ward (IW, n = 54, 72%), PSP (Pathfast, Mitsubishi, Japan) has been measured in addition to routine laboratory tests performed during the period of hospitalization (from January to March 2020).

Results: PSP demonstrates: -statistically significant higher values (Mann-Whitney test) in 6 patients died (median, IQR = 1046, 763-1240; vs 417, 281-678 ng/L, p < 0.05); -statistically significant but poor correlations with CRP (r = 0.59, p < 0.001), LDH (r = 0.52, p < 0.001) and PCT (r = 0.72, p < 0.001) measured at the same day; -a significant relationship between concentrations and ICU stay. In fact patients showing PSP values higher than 250 ng/L (cut-off for risk stratification) did stay in ICU for a significantly longer time (median 17 days, IQR 12-31; p < 0.001) than those exhibiting lower values (median 10 days, IQR 7-18).

Conclusions: The data obtained seems to demonstrate the role of PSP in providing prognostic information in COVID-19 patients, allowing to identify, during the early phase of the monitoring, the patients suffering from a more severe disease which will be hospitalized for a more long time.

Keywords: Biomarkers; Presepsin; Prognosis; SARS-CoV-2 patients.

MeSH terms

  • Aged
  • Betacoronavirus / isolation & purification*
  • Biomarkers / blood
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / therapy
  • Female
  • Hospitalization / trends
  • Humans
  • Length of Stay / trends*
  • Lipopolysaccharide Receptors / blood*
  • Male
  • Middle Aged
  • Pandemics
  • Peptide Fragments / blood*
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / therapy
  • Risk Assessment
  • SARS-CoV-2

Substances

  • Biomarkers
  • Lipopolysaccharide Receptors
  • Peptide Fragments
  • presepsin protein, human