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The following is a summary of “Biomarkers of COVID-19 short-term worsening: a multiparameter analysis within the prospective multicenter COVIDeF cohort,” published in the December 2024 issue of Emergency Medicine by Cancella de Abreu et al.
Pandemics like COVID-19 strain hospital resources, highlighting the need for accurate severity triage.
Researchers conducted a retrospective study to investigate the predictive performance of candidate biomarkers for short-term worsening (STW) of COVID-19.
They screened consecutive individuals with COVID-19 and excluded those meeting severity criteria, including mechanical ventilation (including noninvasive ventilation), ICU admission, acute respiratory distress, or in-hospital death before sampling. Routine blood tests and centralized measurements of biomarkers such as C-reactive protein (CRP), creatine kinase, soluble urokinase plasminogen activator receptor (suPAR), high-sensitive troponin T (TnT-hs),procalcitonin, N-terminal pro-B natriuretic peptide (NT-proBNP), , platelet factor 4, calprotectin, mid-regional pro-adrenomedullin (MR-proADM), and proendothelin were conducted. The primary outcome was STW, which is defined as meeting severity criteria within 7 days. Independent associations were identified using backward stepwise logistic regression and the ‘best subset’ approach, with the area under the receiver operating characteristic (AUROC) was estimated.
The results showed 511 individuals, with 60 (11.7%) experiencing STW. The median time to severity criteria occurrence was 3 days. Predictive factors for worsening at admission included lower eosinophil, lymphocyte, platelet, and alanine aminotransferase levels, and higher neutrophil, creatinine, urea, CRP, TnT-hs, suPAR, NT-proBNP, calprotectin, procalcitonin, MR-proADM, and proendothelin levels. Stepwise logistic regression identified CRP [adjusted odds ratio (aOR): 1.10, 95% confidence interval (95% CI): 1.06–1.15 per 10-unit increase, AUROC: 0.73 (0.66–0.79)], MR-proADM [aOR: 2.85, 95% CI: 1.74–4.69, AUROC: 0.75 (0.69–0.81)] and procalcitonin [aOR: 0.42, 95% CI: 0.22–0.81, AUROC: 0.69 (0.64–0.88)],as significantly associated with worsening. These biomarkers surpassed clinical variables except for diabetes and cancer comorbidities.
Investigators concluded the CRP, procalcitonin, and MR-proADM were independently associated with the risk of short-term worsening in patients with COVID-19.
