Presepsin as a Novel Biomarker in predicting In-hospital Mortality in Patients With COVID-19 Pneumonia

Hebatallah Hany Assal; Safaa Mohamed Abdelrahman; Maha AlyAlden Abdelbasset; Mai Abdelaziz; Irene Mohamed Sabry; Marwa Moawad Shaban

doi:10.1016/j.ijid.2022.02.054

Presepsin as a Novel Biomarker in predicting In-hospital Mortality in Patients With COVID-19 Pneumonia

Int J Infect Dis. 2022 May:118:155-163. doi: 10.1016/j.ijid.2022.02.054. Epub 2022 Mar 3.

Authors

Hebatallah Hany Assal¹, Safaa Mohamed Abdelrahman², Maha AlyAlden Abdelbasset³, Mai Abdelaziz⁴, Irene Mohamed Sabry⁵, Marwa Moawad Shaban⁶

Affiliations

¹ Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: Hebatallah.Assal@kasralainy.edu.eg.
² Department of pediatrics, Faculty of Medicine, Cairo University,Cairo, Egypt. Electronic address: safaa.mohamed5@gmail.com.
³ Department of pediatrics, Faculty of Medicine,Zagazig University, Zagazig, Egypt. Electronic address: maha.aly@gmail.com.
⁴ Biochemistry and molecular biology department, Faculty of Medicine, Badr University in Cairo, Kasr Al Aini Hospital, Cairo University, Cairo, Egypt. Electronic address: maiabdelaziz1979@gmail.com.
⁵ Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: irene.sabry@yahoo.com.
⁶ Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: marwamoawad@ymail.com.

Abstract

Objectives: Different biomarkers such as C-reactive protein (CRP), serum ferritin and D-dimer are used in prognostic assessment of patients with COVID-19 pneumonia. Presepsin (PSP) is a soluble CD14 subtype that has recently been proposed as a novel biomarker in patients with sepsis. The aim of the current study was to detect the relation of PSP to the outcome of COVID-19 as well as its relation to other inflammatory biomarkers.

Methods: This multicenter retrospective observational study was conducted in Saudi Arabia and Misr International Hospital, Egypt, from January 2021 to May 2021. Hospitalised patients who had positive throat swab of SARS-CoV-2 and radiological evidence of viral pneumonia (moderate and severe forms) were included in the study. Demographics and clinical features, as well as laboratory parameters, including serum ferritin, CRP, D-dimer and PSP, of enrolled patients were retrospectively collected. Pneumonia severity index (PSI) was used to evaluate the severity of pneumonia.

Results: A total of 202 hospitalised patients who were diagnosed with COVID-19 pneumonia and tested positive for SARS-CoV-2 RNA were enrolled in our study. Of 202 hospitalised patients, 67 (33.17%) required intensive care unit (ICU) admission. A total of 176 (87.1%) patients survived and were discharged, whereas 26 (12.9%) patients did not survive. PSP level was found to be significantly elevated in nonsurvivor versus survivor group (median [IQR] 978.5 [755.8-1400] vs 516.5 [343.3-720], P<0.001) as well as in ICU versus non-ICU patients (median [IQR] 800 [631-1200] and 446 [320-626], respectively) (P<0.001). Elevated levels were also found to be associated with increased length of hospital stay. Levels above 775 pg/mL were found to be associated with in-hospital mortality (specificity 80%, sensitivity 73%).

Conclusion: Elevated PSP levels indicated poor outcomes in hospitalised patients with COVID-19 pneumonia and were associated with in-hospital mortality.

Keywords: COVID-19; CRP; D-dimer; Ferritin; Presepsin; inflammatory markers; sepsis; soluble CD-14.

Publication types

Multicenter Study
Observational Study

MeSH terms

Biomarkers
C-Reactive Protein
COVID-19* / diagnosis
Ferritins
Hospital Mortality
Humans
Lipopolysaccharide Receptors
Peptide Fragments
Pneumonia, Viral*
RNA, Viral
Retrospective Studies
SARS-CoV-2

Substances

Biomarkers
Lipopolysaccharide Receptors
Peptide Fragments
RNA, Viral
presepsin protein, human
C-Reactive Protein
Ferritins