Host Response Markers of Inflammation and Endothelial Activation Associated with COVID-19 Severity and Mortality: A GeoSentinel Prospective Observational Cohort

AM Weckman, SAJ Guagliardo, VM Crowley, L Moro, C Piubelli, T Ursini, SH van Ierssel, FG Gobbi, H Emetulu, A Rizwan, KM Angelo, C Licitra, BA Connor, S Barkati, M Ngai, KT Zhong, R Huits, Davidson H. Hamer, M Libman, KC Kain

    Research output: Contribution to journalA1: Web of Science-articlepeer-review

    Abstract

    Background:
    The effect of the COVID-19 pandemic on healthcare systems emphasized the need for rapid and effective triage tools to identify patients at risk of severe or fatal infection. Measuring host response markers of inflammation and endothelial activation at clinical presentation may help to inform appropriate triage and care practices in patients with SARS-CoV-2 infection.

    Methods: We enrolled patients with COVID-19 across five GeoSentinel clinical sites (in Italy, Belgium, Canada, and the United States) from September 2020 to December 2021, and analyzed the association of plasma markers, including soluble urokinase-type plasminogen activator receptor (suPAR), soluble tumor necrosis factor receptor-1 (sTREM-1), interleukin-6 (IL-6), interleukin-8 (IL-8), complement component C5a (C5a), von Willebrand factor (VWF-a2), and interleukin-1 receptor antagonist (IL-1Ra), with 28-day (D28) mortality and 7-day (D7) severity (discharged, hospitalized on ward, or died/admitted to the ICU).

    Results: Of 193 patients, 8.9% (16 of 180) died by D28. Higher concentrations of suPAR were associated with increased odds of mortality at D28 and severity at D7 in univariable and multivariable regression models. The biomarkers sTREM-1 and IL-1Ra showed bivariate associations with mortality at D28 and severity at D7. IL-6, VWF, C5a, and IL-8 were not as indicative of progression to severe disease or death.

    Conclusions: Our findings confirm previous studies' assertions that point-of-care tests for suPAR and sTREM-1 could facilitate the triage of patients with SARS-CoV-2 infection, which may help guide hospital resource allocation.
    Original languageEnglish
    Article number1615
    JournalViruses-Basel
    Volume16
    Issue number10
    Number of pages12
    ISSN1999-4915
    DOIs
    Publication statusPublished - 2024

    Keywords

    • COVID-19
    • Host response
    • Morbidity and mortality
    • STREM-1
    • SuPAR

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