Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3
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Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3. / Hansen, Cecilie Bo; Sandholdt, Håkon; Møller, Maria Elizabeth Engel; Pérez-Alós, Laura; Pedersen, Lise; Bastrup Israelsen, Simone; Garred, Peter; Benfield, Thomas.
In: Journal of Innate Immunity, Vol. 14, 2022, p. 493-501.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prediction of Respiratory Failure and Mortality in COVID-19 Patients Using Long Pentraxin PTX3
AU - Hansen, Cecilie Bo
AU - Sandholdt, Håkon
AU - Møller, Maria Elizabeth Engel
AU - Pérez-Alós, Laura
AU - Pedersen, Lise
AU - Bastrup Israelsen, Simone
AU - Garred, Peter
AU - Benfield, Thomas
N1 - Publisher Copyright: © 2022 The Author(s). Published by S. Karger AG, Basel.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - COVID-19
KW - Critical illness
KW - Inflammation
KW - Long pentraxin-3
KW - PTX3
UR - http://www.scopus.com/inward/record.url?scp=85124095553&partnerID=8YFLogxK
U2 - 10.1159/000521612
DO - 10.1159/000521612
M3 - Journal article
C2 - 35066500
AN - SCOPUS:85124095553
VL - 14
SP - 493
EP - 501
JO - Journal of Innate Immunity
JF - Journal of Innate Immunity
SN - 1662-811X
ER -
ID: 321556144