Morgane Ducastel1, Camille Chenevier-Gobeaux1, Yassine Ballaa1, Jean-François Meritet2, Michel Brack3, Nicolas Chapuis4, Frédéric Pene5,6, Nicolas Carlier7,8, Tali-Anne Szwebel9, Nicolas Roche7,8, Benjamin Terrier9,10,11, Didier Borderie1,12. 1. Department of Automated Biological Diagnostic, Cochin Hospital, APHP-Centre Université de Paris, 75014 Paris, France. 2. Department of Virology, Cochin Hospital, APHP-Centre Université de Paris, 75014 Paris, France. 3. The Oxidative Stress College Paris, 75007 Paris, France. 4. Department of Haematology, Cochin Hospital, APHP-Centre Université de Paris, 75014 Paris, France. 5. Medical Intensive Care Unit, Cochin Hospital, APHP-Centre Université de Paris, 75014 Paris, France. 6. INSERM U1016, CNRS UMR 8104, Université de Paris, 75014 Paris, France. 7. Department of Pulmonology, Cochin Hospital, APHP-Centre Université de Paris, 75014 Paris, France. 8. Institut Cochin, UMR 1016, Université de Paris, 75014 Paris, France. 9. Department of Internal Medicine, Cochin Hospital, APHP-Centre Université de Paris, 75014 Paris, France. 10. Centre de Référence Maladies Auto-Immunes et Maladies Systémiques Rares d'Ile-de-France, Université de Paris, 75014 Paris, France. 11. PARCC, INSERM U970, Université de Paris, 75006 Paris, France. 12. INSERM UMRs 1124, Environmental Toxicity, Therapeutic Targets, Cellular Signaling and Biomarkers, Université de Paris, 75006 Paris, France.
Abstract
OBJECTIVE: We aimed to investigate the prognostic performances of oxidative stress (OS), inflammatory and cell activation biomarkers measured at admission in COVID-19 patients. DESIGN: retrospective monocentric study. SETTING: patients with suspected SARS-CoV-2 infection (COVID-19) admitted to the hospital. PATIENTS: One hundred and sixty documented and unselected COVID-19-patients. Disease severity (from mild to critical) was scored according to NIH's classification. INTERVENTIONS: none. MEASUREMENTS AND MAIN RESULTS: We measured OS biomarkers (thiol, advanced oxidation protein products (AOPP), ischemia-modified albumin (IMA)), inflammation biomarkers (interleukin-6 (IL-6), presepsin) and cellular activation biomarkers (calprotectin) in plasma at admission. Thiol concentrations decreased while IMA, IL-6, calprotectin and PSEP increased with disease severity in COVID-19 patients and were associated with increased O2 needs and ICU admission. The best area under the receiver-operating-characteristics curve (AUC) for the prediction of ICU admission was for thiol (AUC = 0.762). A thiol concentration <154 µmol/L was predictive for ICU admission (79.7% sensitivity, 64.6% specificity, 58.8% positive predictive value, 78.9% negative predictive value). In a stepwise logistic regression, we found that being overweight, having dyspnoea, and thiol and IL-6 plasmatic concentrations were independently associated with ICU admission. In contrast, calprotectin was the best biomarker to predict mortality (AUC = 0.792), with an optimal threshold at 24.1 mg/L (94.1% sensitivity, 64.9% specificity, 97.1% positive predictive value and 98.9% negative predictive value), and survival curves indicated that high IL-6 and calprotectin concentrations were associated with a significantly increased risk of mortality. CONCLUSIONS: Thiol measurement at admission is a promising tool to predict ICU admission in COVID-19-patients, whereas IL-6 and calprotectin measurements effectively predict mortality.
OBJECTIVE: We aimed to investigate the prognostic performances of oxidative stress (OS), inflammatory and cell activation biomarkers measured at admission in COVID-19patients. DESIGN: retrospective monocentric study. SETTING:patients with suspected SARS-CoV-2 infection (COVID-19) admitted to the hospital. PATIENTS: One hundred and sixty documented and unselected COVID-19-patients. Disease severity (from mild to critical) was scored according to NIH's classification. INTERVENTIONS: none. MEASUREMENTS AND MAIN RESULTS: We measured OS biomarkers (thiol, advanced oxidation protein products (AOPP), ischemia-modified albumin (IMA)), inflammation biomarkers (interleukin-6 (IL-6), presepsin) and cellular activation biomarkers (calprotectin) in plasma at admission. Thiol concentrations decreased while IMA, IL-6, calprotectin and PSEP increased with disease severity in COVID-19patients and were associated with increased O2 needs and ICU admission. The best area under the receiver-operating-characteristics curve (AUC) for the prediction of ICU admission was for thiol (AUC = 0.762). A thiol concentration <154 µmol/L was predictive for ICU admission (79.7% sensitivity, 64.6% specificity, 58.8% positive predictive value, 78.9% negative predictive value). In a stepwise logistic regression, we found that being overweight, having dyspnoea, and thiol and IL-6 plasmatic concentrations were independently associated with ICU admission. In contrast, calprotectin was the best biomarker to predict mortality (AUC = 0.792), with an optimal threshold at 24.1 mg/L (94.1% sensitivity, 64.9% specificity, 97.1% positive predictive value and 98.9% negative predictive value), and survival curves indicated that high IL-6 and calprotectin concentrations were associated with a significantly increased risk of mortality. CONCLUSIONS:Thiol measurement at admission is a promising tool to predict ICU admission in COVID-19-patients, whereas IL-6 and calprotectin measurements effectively predict mortality.
Authors: Tomasz Wybranowski; Marta Napiórkowska; Maciej Bosek; Jerzy Pyskir; Blanka Ziomkowska; Michał Cyrankiewicz; Małgorzata Pyskir; Marta Pilaczyńska-Cemel; Milena Rogańska; Stefan Kruszewski; Grzegorz Przybylski Journal: Int J Mol Sci Date: 2022-09-03 Impact factor: 6.208