OBJECTIVES: Elevated soluble urokinase Plasminogen Activator Receptor (suPAR) is a biomarker associated with adverse outcomes. We aimed to investigate the associations between plasma suPAR levels (testing the cut-offs ⩽4, 4-6, and ⩾6 ng/mL) with risk of 14-day mortality, and with the risk of mechanical ventilation in patients that tested positive for SARS-CoV-2. METHODS: Observational cohort study of patients presenting with symptoms of COVID-19 at Department of Emergency Medicine, Amager and Hvidovre Hospital, Denmark from March 19th, 2020 to April 3rd, 2020. Plasma suPAR was measured using suPARnostic technologies. Patients were followed for development of mechanical ventilation and mortality for 14 days. Validation of our findings were carried out in a similar sized COVID-19 patient cohort from Mikkeli Central Hospital, Finland. RESULTS: Among 386 patients with symptoms of COVID-19, the median (interquartile range) age was 64 years (46-77), 57% were women, median suPAR was 4.0 ng/mL (2.7-5.9). In total, 35 patients (9.1%) died during the 14 days follow-up. Patients with suPAR ⩽4 ng/mL (N = 196; 50.8%) had a low risk of mortality (N = 2; 1.0%; negative predictive value of 99.0%, specificity 55.3%, sensitivity 95.2%, positive predictive value 17.4%). Among patients with suPAR ⩾6 ng/mL (N = 92; 23.8%), 16 died (17.4%). About 99 patients (25.6%) tested positive for SARS CoV-2 and of those 12 (12.1%) developed need for mechanical ventilation. None of the SARS-CoV-2 positive patients with suPAR ⩽4 ng/mL (N = 28; 38.8%) needed mechanical ventilation or died. The Mikkeli Central Hospital validation cohort confirmed our findings concerning suPAR cut-offs for risk of development of mechanical ventilation and mortality. CONCLUSIONS: Patients with symptoms of COVID-19 and suPAR ⩽4 or ⩾6 ng/mL had low or high risk, respectively, concerning the need for mechanical ventilation or mortality. We suggest cut-offs for identification of risk groups in patients presenting to the ED with symptoms of or confirmed COVID-19.
OBJECTIVES: Elevated soluble urokinase Plasminogen Activator Receptor (suPAR) is a biomarker associated with adverse outcomes. We aimed to investigate the associations between plasma suPAR levels (testing the cut-offs ⩽4, 4-6, and ⩾6 ng/mL) with risk of 14-day mortality, and with the risk of mechanical ventilation in patients that tested positive for SARS-CoV-2. METHODS: Observational cohort study of patients presenting with symptoms of COVID-19 at Department of Emergency Medicine, Amager and Hvidovre Hospital, Denmark from March 19th, 2020 to April 3rd, 2020. Plasma suPAR was measured using suPARnostic technologies. Patients were followed for development of mechanical ventilation and mortality for 14 days. Validation of our findings were carried out in a similar sized COVID-19 patient cohort from Mikkeli Central Hospital, Finland. RESULTS: Among 386 patients with symptoms of COVID-19, the median (interquartile range) age was 64 years (46-77), 57% were women, median suPAR was 4.0 ng/mL (2.7-5.9). In total, 35 patients (9.1%) died during the 14 days follow-up. Patients with suPAR ⩽4 ng/mL (N = 196; 50.8%) had a low risk of mortality (N = 2; 1.0%; negative predictive value of 99.0%, specificity 55.3%, sensitivity 95.2%, positive predictive value 17.4%). Among patients with suPAR ⩾6 ng/mL (N = 92; 23.8%), 16 died (17.4%). About 99 patients (25.6%) tested positive for SARS CoV-2 and of those 12 (12.1%) developed need for mechanical ventilation. None of the SARS-CoV-2 positive patients with suPAR ⩽4 ng/mL (N = 28; 38.8%) needed mechanical ventilation or died. The Mikkeli Central Hospital validation cohort confirmed our findings concerning suPAR cut-offs for risk of development of mechanical ventilation and mortality. CONCLUSIONS: Patients with symptoms of COVID-19 and suPAR ⩽4 or ⩾6 ng/mL had low or high risk, respectively, concerning the need for mechanical ventilation or mortality. We suggest cut-offs for identification of risk groups in patients presenting to the ED with symptoms of or confirmed COVID-19.
Authors: Salim S Hayek; David E Leaf; Ayman Samman Tahhan; Mohamad Raad; Shreyak Sharma; Sushrut S Waikar; Sanja Sever; Alex Camacho; Xuexiang Wang; Ranadheer R Dande; Nasrien E Ibrahim; Rebecca M Baron; Mehmet M Altintas; Changli Wei; David Sheikh-Hamad; Jenny S-C Pan; Michael W Holliday; James L Januzzi; Steven D Weisbord; Arshed A Quyyumi; Jochen Reiser Journal: N Engl J Med Date: 2020-01-30 Impact factor: 91.245
Authors: Tuula K Outinen; Laura Tervo; Satu Mäkelä; Reetta Huttunen; Niina Mäenpää; Heini Huhtala; Antti Vaheri; Jukka Mustonen; Janne Aittoniemi Journal: PLoS One Date: 2013-08-21 Impact factor: 3.240
Authors: Riku Klén; Disha Purohit; Ricardo Gómez-Huelgas; José Manuel Casas-Rojo; Juan Miguel Antón-Santos; Jesús Millán Núñez-Cortés; Carlos Lumbreras; José Manuel Ramos-Rincón; Noelia García Barrio; Miguel Pedrera-Jiménez; Antonio Lalueza Blanco; María Dolores Martin-Escalante; Francisco Rivas-Ruiz; Maria Ángeles Onieva-García; Pablo Young; Juan Ignacio Ramirez; Estela Edith Titto Omonte; Rosmery Gross Artega; Magdy Teresa Canales Beltrán; Pascual Ruben Valdez; Florencia Pugliese; Rosa Castagna; Ivan A Huespe; Bruno Boietti; Javier A Pollan; Nico Funke; Benjamin Leiding; David Gómez-Varela Journal: Elife Date: 2022-05-17 Impact factor: 8.713
Authors: Helena Enocsson; Cornelia Idoff; Annette Gustafsson; Melissa Govender; Francis Hopkins; Marie Larsson; Åsa Nilsdotter-Augustinsson; Johanna Sjöwall Journal: Front Med (Lausanne) Date: 2021-12-02