Presepsin as a predictive indicator of severity in Coronavirus disease-2019 (COVID-19)

Sara M Farag ,Rasha A Nasr,Nesma G El Sheikh,Mona A Khattab

doi:10.21608/nrmj.2021.190249

Abstract

Coronavirus disease 2019 (COVID-19) currently represents a major health emergency worldwide. Early recognition of severe forms of this virus is essential to align effective management and treatment strategies. Presepsin (PSP), the soluble cluster of differentiation (CD14) subtype; is a useful biomarker not only for early diagnosis of sepsis but also could be used as a predictive for the severity and mortality in septic patients, as well as in pneumonia. This study aimed to investigate the potential utility of PSP as a predictive indicator of disease severity in COVID-19 patients. A total of 42 COVID-19 patients were enrolled in this study and stratified into moderate and severe groups, in addition to 15 healthy patients as controls. The PSP levels were measured using Enzyme Linked Immuno-Sorbent Assay (ELISA) within 24 h (1 day) as well as on the 5th day of admission to the Geriatrics hospital, Ain Shams University, Cairo, Egypt, in addition to other relevant laboratory tests performed during the study period from July to October, 2020. Results showed that the PSP levels were significantly higher in COVID-19 patients compared to the controls (p = 0.008) and the 5th day (p = 0.003) of hospital admission. Significant correlation between PSP level and hospital stay (r = 0.332, p = 0.032) was detected; however, no significant correlation was recorded with the different laboratory parameters. For severity prediction, PSP revealed significant values for the 1st day and the 5th day (AUC 0.737; p = 0.003 and AUC 0.810; p < 0.001), respectively. Data obtained in this study suggested the potential utility of PSP as a predictive indicator of severity in COVID-19 patients, thus allowing for earlier identification of high-risk patients and those who will be hospitalized for longer periods.

Highlights

The coronavirus disease 2019 (COVID-19) pandemic caused by the new severe acute respiratory distress syndrome coronavirus (SARS-CoV-2); represents the major current health emergency worldwide since late December, 2019
The demographic and clinical data of the 42 enrolled patients are presented in Table (1), while the laboratory findings on hospital admission are shown in Table (2)
Presepsin (PSP); is a small soluble peptide generated from the monocyte/ macrophage-specific CD14 receptor complex (Chenevier-Gobeaux et al, 2015). This peptide has been indicated in many clinical studies as a useful biomarker for early diagnosis of sepsis, and for risk stratification and prognosis prediction in patients with sepsis, in addition to patients suffering from pneumonia, as revealed by Carpio et al, (2015)

Summary

Introduction

The coronavirus disease 2019 (COVID-19) pandemic caused by the new severe acute respiratory distress syndrome coronavirus (SARS-CoV-2); represents the major current health emergency worldwide since late December, 2019. A recent study of Liu et al, (2020a) reported that COVID-19 was first identified and caused an outbreak of respiratory illness cases in Wuhan City, China, and was later declared as a global pandemic by the World Health Organization (WHO) on 11th of March, 2020. Viral sepsis has been hypothesized as being crucial for the disease mechanism of severe COVID-19 (Li et al, 2020). Many severe or critically ill COVID-19 patients met the diagnostic criteria for sepsis and septic shock (Guan et al, 2019). Huang et al, (2020); Liu et al, (2021) highlighted that pro-inflammatory cytokines and chemokines were significantly elevated in severe COVID-19 patients; suggesting the role of cytokine storm in the immunopathology of COVID19, and its association with severity of this disease (Li et al, 2020)

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