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

• Published in: International journal of infectious diseases Vol. 118; pp. 155 - 163
• Main Authors: Assal, Hebatallah Hany, Abdelrahman, Safaa Mohamed, Abdelbasset, Maha AlyAlden, Abdelaziz, Mai, Sabry, Irene Mohamed, Shaban, Marwa Moawad
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.05.2022; The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Biomarkers; C-Reactive Protein; COVID-19; COVID-19 - diagnosis; CRP; D-dimer; Ferritin; Ferritins; Hospital Mortality; Humans; inflammatory markers; Lipopolysaccharide Receptors; Peptide Fragments; Pneumonia, Viral; Presepsin; Retrospective Studies; RNA, Viral; SARS-CoV-2; sepsis; soluble CD-14; COVID-19; CRP; inflammatory markers; Presepsin; soluble CD-14; Ferritin; D-dimer; sepsis
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2022.02.054

•Elevated presepsin (PSP) in patients with COVID-19 was associated with in-hospital mortality.•Elevated PSP levels indicated poor outcomes in patients with COVID-19.•PSP seems to play an important pathogenetic role in COVID-19 acute respiratory distress syndrome (ARDS). 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. 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. 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%). Elevated PSP levels indicated poor outcomes in hospitalised patients with COVID-19 pneumonia and were associated with in-hospital mortality.