Soluble urokinase Plasminogen Activator Receptor (suPAR) levels are predictive of COVID-19 severity: an Italian experience.
COVID-19
Inflammatory markers
Respiratory support
Risk assessment
suPAR
Journal
Clinical immunology (Orlando, Fla.)
ISSN: 1521-7035
Titre abrégé: Clin Immunol
Pays: United States
ID NLM: 100883537
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
received:
27
06
2022
revised:
23
07
2022
accepted:
25
07
2022
pubmed:
10
8
2022
medline:
14
9
2022
entrez:
9
8
2022
Statut:
ppublish
Résumé
The soluble urokinase Plasminogen Activator Receptor (suPAR) has been identified as a reliable marker of COVID-19 severity, helping in personalizing COVID-19 therapy. This study aims to evaluate the correlation between suPAR levels and COVID-19 severity, in relation to the traditional inflammatory markers. Sera from 71 COVID-19 patients were tested for suPAR levels using Chorus suPAR assay (Diesse Diagnostica Senese SpA, Italy). suPAR levels were compared with other inflammatory markers: IL-1β, IL-6, TNF-α, circulating calprotectin, neutrophil and lymphocyte counts, and Neutrophil/Lymphocytes Ratio (NLR). Respiratory failure, expressed as P/F ratio, and mortality rate were used as indicators of disease severity. A positive correlation of suPAR levels with IL-6 (r = 0.479, p = 0.000), TNF-α (r = 0.348, p = 0.003), circulating calprotectin (r = 0.369, p = 0.002), neutrophil counts (r = 0.447, p = 0.001), NLR (r = 0.492, p = 0.001) has been shown. Stratifying COVID-19 population by suPAR concentration above and below 6 ng/mL, we observed higher levels of circulating calprotectin (10.1 μg/mL, SD 7.9 versus 6.4 μg/mL, SD 7.5, p < 0.001), higher levels of P/F ratio (207.5 IQR 188.3 vs 312.0 IQR 127.8, p = 0.013) and higher mortality rate. Median levels of suPAR were increased in all COVID-19 patients requiring additional respiratory support (Nasal Cannula, Venturi Mask, BPAP and CPAP) (6.5 IQR = 4.9) compared to the group at room air (4.6 IQR = 4.2). suPAR levels correlate with disease severity and survival rate of COVID-19 patients, representing a promising prognostic biomarker for the risk assessment of the disease.
Sections du résumé
BACKGROUND
The soluble urokinase Plasminogen Activator Receptor (suPAR) has been identified as a reliable marker of COVID-19 severity, helping in personalizing COVID-19 therapy. This study aims to evaluate the correlation between suPAR levels and COVID-19 severity, in relation to the traditional inflammatory markers.
METHODS
Sera from 71 COVID-19 patients were tested for suPAR levels using Chorus suPAR assay (Diesse Diagnostica Senese SpA, Italy). suPAR levels were compared with other inflammatory markers: IL-1β, IL-6, TNF-α, circulating calprotectin, neutrophil and lymphocyte counts, and Neutrophil/Lymphocytes Ratio (NLR). Respiratory failure, expressed as P/F ratio, and mortality rate were used as indicators of disease severity.
RESULTS
A positive correlation of suPAR levels with IL-6 (r = 0.479, p = 0.000), TNF-α (r = 0.348, p = 0.003), circulating calprotectin (r = 0.369, p = 0.002), neutrophil counts (r = 0.447, p = 0.001), NLR (r = 0.492, p = 0.001) has been shown. Stratifying COVID-19 population by suPAR concentration above and below 6 ng/mL, we observed higher levels of circulating calprotectin (10.1 μg/mL, SD 7.9 versus 6.4 μg/mL, SD 7.5, p < 0.001), higher levels of P/F ratio (207.5 IQR 188.3 vs 312.0 IQR 127.8, p = 0.013) and higher mortality rate. Median levels of suPAR were increased in all COVID-19 patients requiring additional respiratory support (Nasal Cannula, Venturi Mask, BPAP and CPAP) (6.5 IQR = 4.9) compared to the group at room air (4.6 IQR = 4.2).
CONCLUSION
suPAR levels correlate with disease severity and survival rate of COVID-19 patients, representing a promising prognostic biomarker for the risk assessment of the disease.
Identifiants
pubmed: 35944880
pii: S1521-6616(22)00172-3
doi: 10.1016/j.clim.2022.109091
pmc: PMC9356594
pii:
doi:
Substances chimiques
Biomarkers
0
Interleukin-6
0
Leukocyte L1 Antigen Complex
0
Receptors, Urokinase Plasminogen Activator
0
Tumor Necrosis Factor-alpha
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
109091Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Helena Cerutti, Giulia Tesi, Valentina Anrò are employees of Diesse Diagnostica Senese SpA (Siena, Italy). The other authors have no conflict of interests.
Références
Anaesth Crit Care Pain Med. 2020 Dec;39(6):723-730
pubmed: 33172592
Chest. 1993 Feb;103(2):565-75
pubmed: 8432155
Cytokine Growth Factor Rev. 2020 Jun;53:13-24
pubmed: 32475759
Crit Care. 2012 Aug 08;16(4):R149
pubmed: 22873681
Thromb Haemost. 1999 Aug;82(2):305-11
pubmed: 10605718
Crit Care. 2020 May 15;24(1):228
pubmed: 32414403
J Infect. 2020 Jun;80(6):656-665
pubmed: 32283155
Expert Rev Clin Immunol. 2021 May;17(5):431-443
pubmed: 33750254
Ann Lab Med. 2021 Nov 1;41(6):540-548
pubmed: 34108281
PLoS One. 2020 Sep 17;15(9):e0239235
pubmed: 32941548
Crit Rev Clin Lab Sci. 2020 Sep;57(6):389-399
pubmed: 32503382
Arthritis Rheum. 2010 Jan;62(1):93-104
pubmed: 20039430
Blood. 1990 Jan 1;75(1):40-7
pubmed: 2294996
N Engl J Med. 2020 Jan 30;382(5):416-426
pubmed: 31995687
JAMA Intern Med. 2020 Oct 1;180(10):1345-1355
pubmed: 32667669
J Med Virol. 2020 Oct;92(10):1733-1734
pubmed: 32242950
Transl Res. 2021 Jun;232:142-149
pubmed: 33582243
Stem Cells. 1997;15(6):398-408
pubmed: 9402652
Diabet Med. 2012 Apr;29(4):479-87
pubmed: 22050462
Front Med (Lausanne). 2020 Aug 13;7:526
pubmed: 32903492
Nat Rev Mol Cell Biol. 2010 Jan;11(1):23-36
pubmed: 20027185
Mediators Inflamm. 2013;2013:165974
pubmed: 23853427
Biomark Insights. 2021 Aug 15;16:11772719211034685
pubmed: 34421295
J Clin Med. 2021 Oct 24;10(21):
pubmed: 34768433
J Med Virol. 2021 Mar;93(3):1665-1671
pubmed: 32946118
Elife. 2021 Mar 08;10:
pubmed: 33682678
Am J Clin Pathol. 1994 Dec;102(6):835-41
pubmed: 7801901
Clin Chem Lab Med. 2021 Jun 14;59(11):e413-e415
pubmed: 34116589
Br J Surg. 1998 Jun;85(6):818-25
pubmed: 9667716
Thromb Res. 2020 Dec;196:308-312
pubmed: 32977128
J Innate Immun. 2022;14(6):643-656
pubmed: 35545011
Shock. 2000 Jul;14(1):73-8
pubmed: 10909897
Clin Chem Lab Med. 2020 Jun 25;58(7):1021-1028
pubmed: 32286245
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Swiss Med Wkly. 2020 Mar 24;150:w20227
pubmed: 32208493
Emerg Med J. 2021 Jul;38(7):543-548
pubmed: 34021028
BMC Emerg Med. 2021 Nov 29;21(1):149
pubmed: 34844557
Int J Infect Dis. 2021 Jun;107:188-194
pubmed: 33862208
Crit Care. 2020 Apr 30;24(1):187
pubmed: 32354367
J Clin Med Res. 2021 Sep;13(9):474-478
pubmed: 34691321
Indian J Crit Care Med. 2020 Nov;24(Suppl 5):S244-S253
pubmed: 33354048
Biomark Med. 2022 Feb;16(3):169-177
pubmed: 35081737
Shock. 2020 Apr;53(4):416-425
pubmed: 31490358
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
J Am Soc Nephrol. 2020 Nov;31(11):2725-2735
pubmed: 32963090
Front Med (Lausanne). 2021 Dec 02;8:791716
pubmed: 34926532
Int Immunopharmacol. 2020 Jul;84:106504
pubmed: 32304994
Pharmacol Res. 2018 Aug;134:31-39
pubmed: 29859810
Circulation. 2021 Mar 30;143(13):1338-1340
pubmed: 33587646
Crit Care. 2020 Dec 29;24(1):704
pubmed: 33372603
Crit Care Med. 1989 Oct;17(10):975-8
pubmed: 2791581
Lancet Rheumatol. 2021 Oct;3(10):e690-e697
pubmed: 34396156
Rev Med Virol. 2020 Nov;30(6):1-9
pubmed: 32845568