Potential biochemical markers to identify severe cases among COVID-19 patients

Xiang, Jianlin; Wen, Jing; Yuan, Xiaoqing; Xiong, Shengwu; Zhou, Xue; Liu, Changjin; Min, Xun

doi:10.1101/2020.03.19.20034447

Cited by 65 publications

(62 citation statements)

References 5 publications

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“…The model identified serum concentrations of cholinesterase, calcium, and eGFR as predictors, and elevation of the three markers associated with the risk of recurrence of PCR positivity. Previous studies found that increased levels of cholinesterase, calcium, and eGFR were associated with mild COVID-19 [32][33][34] . In our study, mild or moderate patients more likely to recur with PCR positivity post discharge.…”

Section: Discussionmentioning

confidence: 93%

Recurrence of SARS-CoV-2 PCR positivity in COVID-19 patients: a single center experience and potential implications

Huang

Zheng

et al. 2020

Preprint

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IMPORTANCE How to appropriately care for patients who become PCR-negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still not known.Patients who have recovered from coronavirus disease 2019 (COVID-19) could profoundly impact the health care system if a subset were to be PCR-positive again with reactivated SARS-CoV-2.OBJECTIVE To characterize a single center COVID-19 cohort with and without recurrence of PCR positivity, and develop an algorithm to identify patients at high risk of retest positivity after discharge to inform health care policy and case management decision-making. DESIGN, SETTING, AND PARTICIPANTSA cohort of 414 patients with confirmed SARS-CoV-2 infection, at The Second Affiliated EXPOSURES Polymerase chain reaction (PCR) and IgM-IgG antibody confirmed SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES Univariable and multivariable statistical analysis of the clinical, laboratory, radiologic image, medical treatment, and clinical course of admission/quarantine/readmission data to develop an algorithm to predict patients at risk of recurrence of PCR positivity.RESULTS 16.7% (95CI: 13.0%-20.3%) patients retest PCR positive 1 to 3 times after discharge, despite being in strict quarantine. The driving factors in the recurrence prediction model included: age, BMI; lowest levels of the blood laboratory tests

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Section: Discussionmentioning

confidence: 93%

Recurrence of SARS-CoV-2 PCR positivity in COVID-19 patients: a single center experience and potential implications

Huang

Zheng

et al. 2020

Preprint

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“…Xiang, J. et al showed that non-survivors patients presented increase in IL-6, serum urea, creatinine, cystatin C, direct bilirubin, and cholinesterase [42]. ROC curve, used to analyze the specificity and sensitivity of different variables COVID-19 patients, indicated that IL-6, PSP, He4 reflect the clinical course of the disease and might be used to predict the evolution of COVID-19 disease.…”

Section: Roc Curves Analysis Is Shown Inmentioning

confidence: 99%

New Insights in Laboratory Testing for COVID-19 Patients: Looking for the Role and Predictive Value of Human epididymis secretory protein 4 (HE4) and the Innate Immunity of the Oral Cavity and Respiratory Tract

et al. 2020

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COVID-19 is a viral pandemic caused by the new coronavirus SARS-CoV-2, an enveloped positive stranded RNA virus. The mechanisms of innate immunity, considered as the first line of antiviral defense, is essential towards viruses. A significant role in host defense of the lung, nasal and oral cavities is played by Human epididymis secretory protein 4 (HE4) HE4 has been demonstrated to be serum inflammatory biomarker and to show a role in natural immunity at the level of oral cavity, nasopharynx and respiratory tract with both antimicrobial/antiviral and anti-inflammatory activity. Several biomarkers like IL-6, presepsin (PSP), procalcitonin (PCT), CRP, D-Dimer have showed a good function as predictor factors for the clinical evolution of COVID-19 patients (mild, severe and critical). The aim of this study was to correlate the blood levels of CRP, IL-6, PSP, PCT, D-Dimer with He4, to identify the predictive values of these biomarkers for the evolution of the disease and to evaluate the possible role of HE4 in the defense mechanisms of innate immunity at the level of oral cavity, nasopharynx and respiratory tract. Of 134 patients admitted at COVID hospital of Policlinico—University of Bari, 86 (58 men age 67.6 ± 12.4 and 28 women age 65.7 ± 15.4) fulfilled the inclusion criteria: in particular, 80 patients (93%) showed prodromal symptoms (smell and/or taste dysfunctions) and other typical clinical manifestations and 19 died (13 men age 73.4 ± 7.7 and 6 women age 74.8 ± 6.7). 48 patients were excluded because 13 finished chemotherapy and 6 radiotherapy recently, 5 presented suspected breast carcinoma, 5 suspected lung carcinoma, 6 suspected ovarian carcinoma or ovary cyst, 1 cystic fibrosis, 3 renal fibrosis and 9 were affected by autoimmune diseases in treatment with monoclonal antibodies. The venous sample was taken for each patient on the admission and during the hospital stay. For each patient, six measurements relating to considered parameters were performed. Significant correlations between He4 and IL-6 levels (r = 0.797), between He4 and PSP (r = 0.621), between He4 and PCT (r = 0.447), between He4 and D-Dimer (r = 0.367), between He4 and RCP (r = 0.327) have been found. ROC curves analysis showed an excellent accuracy for He4 (AUC = 0.92) and IL-6 (AUC = 0.91), a very good accuracy for PSP (AUC = 0.81), a good accuracy for PCT (AUC = 0.701) and D-Dimer (AUC = 0.721) and sufficient accuracy for RCP (AUC = 0.616). These results demonstrated the important correlation between He4, IL6 and PSP, an excellent accuracy of He4 and IL6 and showed a probable role of He4 in the innate immunity in particularly at the level of oral cavity, nasopharynx and respiratory tract. Besides He4 together with IL6 might be involved in the onset of smell and/or taste disorders and it might be used as innovative biomarker to monitor clinical evolution of COVID-19 because He4 could indicate a multi-organ involvement.

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“…T cells along with downregulation of IFN-c expression in severe cases was also observed [7]. In another pre-print, Xiang et al reported serum urea, creatinine and cystatin C may be potential biomarkers in severity of COVID-19 [8]. Huang et al reported higher plasma levels of interleukins (IL-2, IL-7, IL-10) and other inflammatory markers (GSCF, IP10, MCP1, MIP1A and TNF-a) in COVID-19 patients requiring ICU care versus non-ICU patients [9].…”

mentioning

confidence: 86%