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Clinical Trial
. 2022 Feb;16(3):169-177.
doi: 10.2217/bmm-2021-0669. Epub 2022 Jan 27.

Soluble urokinase plasminogen activator receptor levels are predictive of COVID-19 severity in Afro-Caribbean patients

Mael Padelli  1 , Papa Gueye  2 , Diane Guilloux  3 , Rishika Banydeen  4 , Valentine Campana  5 , Andre Cabie  6 , Remi Neviere  7   8
Affiliations
Clinical Trial

Soluble urokinase plasminogen activator receptor levels are predictive of COVID-19 severity in Afro-Caribbean patients

Mael Padelli et al. Biomark Med. 2022 Feb.

Abstract

Aim: To investigate association between soluble urokinase plasminogen activator receptor (suPAR) plasma levels at admission and incidence of complications in COVID-19 patients. Patients & methods: We considered Afro-Caribbean patients (n = 64) admitted to the hospital between 1 February 2020 and 28 February 2021. Primary outcome was time from the hospital admission until intensive care unit care or death. Results: Primary outcome (hazard ratio, HR [95%CI]) was associated with higher CT scan severity score (3.18 [1.15-8.78], p = 0.025), National Early Warning Score (NEWS2; 1.43 [1.02-2.02], p = 0.041) and suPAR (1.28 [1.06-2.06], p = 0.041). Kaplan-Meier analysis indicated patients with suPAR level above 8.95 ng/ml had a worse outcome (7.95 [3.33-18.97], p < 0.001). Conclusion: Our study suggests that COVID-19 patients with increased baseline suPAR levels are at a high risk of complications.

Keywords: Afro-Caribbean; COVID-19; National Early Warning Score; chest CT severity score; intensive care; soluble urokinase plasminogen activator receptor.

Plain language summary

Plain language summary Our aim was to investigate association between the plasma levels of soluble urokinase plasminogen activator receptor (suPAR) at admission and incidence of complications in COVID-19 patients. Increased suPAR level has been previously associated with activation of inflammation and coagulation, which important features of COVID-19. We considered Afro-Caribbean patients admitted to the hospital between 1 February 2020 and 28 February 2021. Primary outcome was time from the hospital admission until intensive care unit care or death. The use of an integrative prediction tool which combines simple clinical score (NEWS2), imaging technique (chest CT severity score) and suPAR plasma levels has potent predictive value for COVID-19 outcome.

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Figures

Figure 1.
Figure 1.. Study flowchart.
Figure 2.
Figure 2.. Receiver-operating characteristic analysis for the prediction of outcome (intensive care unit admission or death) (soluble urokinase plasminogen activator receptor).
ROC-derived cutoff for plasma suPAR concentration was 8.95 ng/ml (AUC: 0.834, sensibility 78%, specificity 76%). AUC: Area under the curve; ROC: Receiver-operating characteristic; suPAR: Soluble urokinase plasminogen activator receptor.
Figure 3.
Figure 3.. Kaplan–Meier survival curves from the Cox model for primary outcome (composite of intensive care unit admission or death) for plasma-soluble urokinase plasminogen activator receptor levels.
A log-rank test stratified by group indicated a significant difference in the survival curves (HR: 7.95 [95% CI: 3.33–18.97]; p < 0.001). HR: Hazard ratio.
Figure 4.
Figure 4.. Box plot of plasma-soluble urokinase plasminogen activator receptor levels (ng/ml) in COVID patients with and without primary outcome defined as intensive care unit admission requiring noninvasive or mechanical ventilation or death.
*Indicates p < 0.05 (the Mann–Whitney U test). Median (plain line) and mean (dashed line) are displayed.
See this image and copyright information in PMC

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