Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19
Abstract Background A prospective observational cohort study of COVID-19 patients in a single Emergency Department (ED) showed that sTREM-1- and IL-6-based algorithms were highly predictive of adverse outcome (Van Singer et al. J Allergy Clin Immunol 2021). We aim to validate the performance of thes...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08630-0 |
| _version_ | 1827635515680096256 |
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| author | Mathias Van Singer Thomas Brahier Jana Koch Pr. Olivier Hugli Andrea M. Weckman Kathleen Zhong Taylor J. Kain Aleksandra Leligdowicz Enos Bernasconi Alessandro Ceschi Sara Parolari Danielle Vuichard-Gysin Kevin C. Kain Werner C. Albrich Noémie Boillat-Blanco |
| author_facet | Mathias Van Singer Thomas Brahier Jana Koch Pr. Olivier Hugli Andrea M. Weckman Kathleen Zhong Taylor J. Kain Aleksandra Leligdowicz Enos Bernasconi Alessandro Ceschi Sara Parolari Danielle Vuichard-Gysin Kevin C. Kain Werner C. Albrich Noémie Boillat-Blanco |
| author_sort | Mathias Van Singer |
| collection | DOAJ |
| description | Abstract Background A prospective observational cohort study of COVID-19 patients in a single Emergency Department (ED) showed that sTREM-1- and IL-6-based algorithms were highly predictive of adverse outcome (Van Singer et al. J Allergy Clin Immunol 2021). We aim to validate the performance of these algorithms at ED presentation. Methods This multicentric prospective observational study of PCR-confirmed COVID-19 adult patients was conducted in the ED of three Swiss hospitals. Data of the three centers were retrospectively completed and merged. We determined the predictive accuracy of the sTREM-1-based algorithm for 30-day intubation/mortality. We also determined the performance of the IL-6-based algorithm using data from one center for 30-day oxygen requirement. Results 373 patients were included in the validation cohort, 139 (37%) in Lausanne, 93 (25%) in St.Gallen and 141 (38%) in EOC. Overall, 18% (93/373) patients died or were intubated by day 30. In Lausanne, 66% (92/139) patients required oxygen by day 30. The predictive accuracy of sTREM-1 and IL-6 were similar compared to the derivation cohort. The sTREM-1-based algorithm confirmed excellent sensitivity (90% versus 100% in the derivation cohort) and negative predictive value (94% versus 100%) for 30-day intubation/mortality. The IL-6-based algorithm performance was acceptable with a sensitivity of 85% versus 98% in the derivation cohort and a negative predictive value of 60% versus 92%. Conclusion The sTREM-1 algorithm demonstrated good reproducibility. A prospective randomized controlled trial, comparing outcomes with and without the algorithm, is necessary to assess its safety and impact on hospital and ICU admission rates. The IL-6 algorithm showed acceptable validity in a single center and need additional validation before widespread implementation. |
| first_indexed | 2024-03-09T15:27:47Z |
| format | Article |
| id | doaj.art-e71e1f5eb2f2406a8c0bdceb09f9d96a |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-09T15:27:47Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e71e1f5eb2f2406a8c0bdceb09f9d96a2023-11-26T12:26:49ZengBMCBMC Infectious Diseases1471-23342023-09-012311810.1186/s12879-023-08630-0Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19Mathias Van Singer0Thomas Brahier1Jana Koch2Pr. Olivier Hugli3Andrea M. Weckman4Kathleen Zhong5Taylor J. Kain6Aleksandra Leligdowicz7Enos Bernasconi8Alessandro Ceschi9Sara Parolari10Danielle Vuichard-Gysin11Kevin C. Kain12Werner C. Albrich13Noémie Boillat-Blanco14Infectious Diseases Service, University Hospital of LausanneInfectious Diseases Service, University Hospital of LausanneDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.GallenEmergency Department, University Hospital of LausanneTropical Disease Unit, Department of Medicine, Sandra Rotman Centre for Global Health, University of Toronto, University Health Network-Toronto GeneralTropical Disease Unit, Department of Medicine, Sandra Rotman Centre for Global Health, University of Toronto, University Health Network-Toronto GeneralTropical Disease Unit, Department of Medicine, Sandra Rotman Centre for Global Health, University of Toronto, University Health Network-Toronto GeneralDepartment of Medicine, Western UniversityDivision of infectious diseases, Ente Ospedaliero Cantonale, University of Geneva and University of Southern SwitzerlandDivision of infectious diseases, Ente Ospedaliero Cantonale, University of Geneva and University of Southern SwitzerlandDepartment of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Muensterlingen, Thurgau Hospital GroupDepartment of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Muensterlingen, Thurgau Hospital GroupTropical Disease Unit, Department of Medicine, Sandra Rotman Centre for Global Health, University of Toronto, University Health Network-Toronto GeneralDivision of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.GallenInfectious Diseases Service, University Hospital of LausanneAbstract Background A prospective observational cohort study of COVID-19 patients in a single Emergency Department (ED) showed that sTREM-1- and IL-6-based algorithms were highly predictive of adverse outcome (Van Singer et al. J Allergy Clin Immunol 2021). We aim to validate the performance of these algorithms at ED presentation. Methods This multicentric prospective observational study of PCR-confirmed COVID-19 adult patients was conducted in the ED of three Swiss hospitals. Data of the three centers were retrospectively completed and merged. We determined the predictive accuracy of the sTREM-1-based algorithm for 30-day intubation/mortality. We also determined the performance of the IL-6-based algorithm using data from one center for 30-day oxygen requirement. Results 373 patients were included in the validation cohort, 139 (37%) in Lausanne, 93 (25%) in St.Gallen and 141 (38%) in EOC. Overall, 18% (93/373) patients died or were intubated by day 30. In Lausanne, 66% (92/139) patients required oxygen by day 30. The predictive accuracy of sTREM-1 and IL-6 were similar compared to the derivation cohort. The sTREM-1-based algorithm confirmed excellent sensitivity (90% versus 100% in the derivation cohort) and negative predictive value (94% versus 100%) for 30-day intubation/mortality. The IL-6-based algorithm performance was acceptable with a sensitivity of 85% versus 98% in the derivation cohort and a negative predictive value of 60% versus 92%. Conclusion The sTREM-1 algorithm demonstrated good reproducibility. A prospective randomized controlled trial, comparing outcomes with and without the algorithm, is necessary to assess its safety and impact on hospital and ICU admission rates. The IL-6 algorithm showed acceptable validity in a single center and need additional validation before widespread implementation.https://doi.org/10.1186/s12879-023-08630-0BiomarkersValidation studyCOVID-19sTREM-1Clinical support decision tool |
| spellingShingle | Mathias Van Singer Thomas Brahier Jana Koch Pr. Olivier Hugli Andrea M. Weckman Kathleen Zhong Taylor J. Kain Aleksandra Leligdowicz Enos Bernasconi Alessandro Ceschi Sara Parolari Danielle Vuichard-Gysin Kevin C. Kain Werner C. Albrich Noémie Boillat-Blanco Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19 BMC Infectious Diseases Biomarkers Validation study COVID-19 sTREM-1 Clinical support decision tool |
| title | Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19 |
| title_full | Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19 |
| title_fullStr | Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19 |
| title_full_unstemmed | Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19 |
| title_short | Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19 |
| title_sort | validation of strem 1 and il 6 based algorithms for outcome prediction of covid 19 |
| topic | Biomarkers Validation study COVID-19 sTREM-1 Clinical support decision tool |
| url | https://doi.org/10.1186/s12879-023-08630-0 |
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