Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3
The course of COVID-19 is unpredictable, ranging from asymptomatic to respiratory failure and death. Prognostic biomarkers are urgently needed. We hypothesized that long pentraxin PTX3 could be a valuable plasma biomarker due to its essential role in inflammatory processes. In a prospective hospital...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-01-01
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| Series: | Journal of Innate Immunity |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/521612 |
| _version_ | 1818297122440609792 |
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| author | Cecilie Bo Hansen Håkon Sandholdt Maria Elizabeth Engel Møller Laura Pérez-Alós Lise Pedersen Simone Bastrup Israelsen Peter Garred Thomas Benfield |
| author_facet | Cecilie Bo Hansen Håkon Sandholdt Maria Elizabeth Engel Møller Laura Pérez-Alós Lise Pedersen Simone Bastrup Israelsen Peter Garred Thomas Benfield |
| author_sort | Cecilie Bo Hansen |
| collection | DOAJ |
| description | The course of COVID-19 is unpredictable, ranging from asymptomatic to respiratory failure and death. Prognostic biomarkers are urgently needed. We hypothesized that long pentraxin PTX3 could be a valuable plasma biomarker due to its essential role in inflammatory processes. In a prospective hospitalized COVID-19 derivation cohort (n = 126) during the spring of 2020, we measured PTX3 within 4 days of admission. The predictive value of mechanical ventilation (MV) and 30-day mortality compared with clinical parameters and other markers of inflammation were assessed by logistic regression analysis and expressed as odds ratio (OR) with 95% confidence interval (CI). Analyses were repeated in a prospective validation cohort (n = 112) of hospitalized patients with COVID-19 treated with remdesivir and dexamethasone. Thirty-day mortality in the derivation cohort was 26.2%. In patients who died, the median PTX3 concentration upon admission was 19.5 ng/mL (IQR: 12.5–33.3) versus 6.6 ng/mL (IQR 2.9–12.3) (p < 0.0001) for survivors. After adjustment for covariates, the odds of 30-day mortality increased two-fold for each doubling of PTX3 (OR 2.03 [95% CI: 1.23–3.34], p = 0.006), which was also observed in the validation cohort (OR 1.70 [95% CI: 1.09–2.67], p = 0.02). Similarly, PTX3 levels were associated with MV. After adjustment for covariates, OR of MV was 2.34 (95% CI: 1.33–4.12, p = 0.003) in the derivation cohort and 1.64 (95% CI: 1.03–2.62, p = 0.04) in the validation cohort. PTX3 appears to be a useful clinical biomarker to predict 30-day respiratory failure and mortality risk in COVID-19 patients treated with and without remdesivir and dexamethasone. |
| first_indexed | 2024-12-13T04:14:25Z |
| format | Article |
| id | doaj.art-a06889577a174ecc8a7129ee45bdbe31 |
| institution | Directory Open Access Journal |
| issn | 1662-811X 1662-8128 |
| language | English |
| last_indexed | 2024-12-13T04:14:25Z |
| publishDate | 2022-01-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Journal of Innate Immunity |
| spelling | doaj.art-a06889577a174ecc8a7129ee45bdbe312022-12-21T23:59:55ZengKarger PublishersJournal of Innate Immunity1662-811X1662-81282022-01-011910.1159/000521612521612Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3Cecilie Bo Hansen0https://orcid.org/0000-0002-7709-4522Håkon Sandholdt1Maria Elizabeth Engel Møller2Laura Pérez-Alós3https://orcid.org/0000-0002-0368-4976Lise Pedersen4https://orcid.org/0000-0002-0057-208XSimone Bastrup Israelsen5https://orcid.org/0000-0002-0653-1289Peter Garred6https://orcid.org/0000-0002-2876-8586Thomas Benfield7https://orcid.org/0000-0003-0698-9385Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet University Hospital, Copenhagen, DenmarkDepartment of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, DenmarkDepartment of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, DenmarkLaboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet University Hospital, Copenhagen, DenmarkDepartment of Clinical Biochemistry, Holbaek Hospital, Holbaek, DenmarkDepartment of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, DenmarkLaboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet University Hospital, Copenhagen, DenmarkDepartment of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, DenmarkThe course of COVID-19 is unpredictable, ranging from asymptomatic to respiratory failure and death. Prognostic biomarkers are urgently needed. We hypothesized that long pentraxin PTX3 could be a valuable plasma biomarker due to its essential role in inflammatory processes. In a prospective hospitalized COVID-19 derivation cohort (n = 126) during the spring of 2020, we measured PTX3 within 4 days of admission. The predictive value of mechanical ventilation (MV) and 30-day mortality compared with clinical parameters and other markers of inflammation were assessed by logistic regression analysis and expressed as odds ratio (OR) with 95% confidence interval (CI). Analyses were repeated in a prospective validation cohort (n = 112) of hospitalized patients with COVID-19 treated with remdesivir and dexamethasone. Thirty-day mortality in the derivation cohort was 26.2%. In patients who died, the median PTX3 concentration upon admission was 19.5 ng/mL (IQR: 12.5–33.3) versus 6.6 ng/mL (IQR 2.9–12.3) (p < 0.0001) for survivors. After adjustment for covariates, the odds of 30-day mortality increased two-fold for each doubling of PTX3 (OR 2.03 [95% CI: 1.23–3.34], p = 0.006), which was also observed in the validation cohort (OR 1.70 [95% CI: 1.09–2.67], p = 0.02). Similarly, PTX3 levels were associated with MV. After adjustment for covariates, OR of MV was 2.34 (95% CI: 1.33–4.12, p = 0.003) in the derivation cohort and 1.64 (95% CI: 1.03–2.62, p = 0.04) in the validation cohort. PTX3 appears to be a useful clinical biomarker to predict 30-day respiratory failure and mortality risk in COVID-19 patients treated with and without remdesivir and dexamethasone.https://www.karger.com/Article/FullText/521612long pentraxin-3ptx3covid-19inflammationcritical illness |
| spellingShingle | Cecilie Bo Hansen Håkon Sandholdt Maria Elizabeth Engel Møller Laura Pérez-Alós Lise Pedersen Simone Bastrup Israelsen Peter Garred Thomas Benfield Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3 Journal of Innate Immunity long pentraxin-3 ptx3 covid-19 inflammation critical illness |
| title | Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3 |
| title_full | Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3 |
| title_fullStr | Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3 |
| title_full_unstemmed | Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3 |
| title_short | Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3 |
| title_sort | prediction of respiratory failure and mortality in covid 19 patients using long pentraxin ptx3 |
| topic | long pentraxin-3 ptx3 covid-19 inflammation critical illness |
| url | https://www.karger.com/Article/FullText/521612 |
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