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The following is a summary of “Shock prediction with dipeptidyl peptidase-3 and renin (SPiDeR) in hypoxemic patients with COVID-19,” published in the February 2025 issue of Journal of Critical Care by Busse et al. 

Researchers conducted a retrospective study to examine the association of plasma dipeptidyl peptidase-3 (DPP3) and renin levels with the subsequent onset of shock in individuals at-risk.  

They analyzed plasma samples from 184 individuals hospitalized with acute hypoxemia from COVID-19, enrolled in the fourth Accelerating COVID-19 Therapeutic Interventions and Vaccines Host Tissue platform trial. The DPP3 and renin levels were measured on Day 0 in those without baseline vasopressor requirements. The odds ratio for developing shock, defined as vasopressor initiation, was calculated by Day 28 based on Day 0 biomarker levels.  

The results showed that individuals with DPP3 levels above the median had a higher incidence of vasopressor initiation within 28 days (28.4% vs 16.7%, P = 0.031) and increased 28-day mortality (25.0% vs 6.7%, P < 0.001). After adjusting for covariables, elevated DPP3 was linked to a shorter time to vasopressor initiation, higher 28-day mortality, fewer vasopressor-free days, and increased odds of a hypotensive event over 7 days and no significant associations were observed for renin.  

Investigators concluded that in patients hospitalized with COVID-19 along with hypoxemia and without initial hypotension, elevated DPP3, but not renin, levels predicted a greater risk of subsequent shock and mortality. 

Source: sciencedirect.com/science/article/abs/pii/S0883944124004374