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Observational Study
. 2022 Jul;52(7):e13794.
doi: 10.1111/eci.13794. Epub 2022 May 4.

Circulating suPAR associates with severity and in-hospital progression of COVID-19

Athanasios Chalkias  1   2 , Anargyros Skoulakis  1 , Nikolaos Papagiannakis  3 , Eleni Laou  1 , Konstantinos Tourlakopoulos  4 , Athanasios Pagonis  4 , Anastasia Michou  1 , Nicoletta Ntalarizou  1 , Maria Mermiri  1 , Dimitrios Ragias  1 , Enrique Bernal-Morell  5 , Iria Cebreiros López  6 , Luis García de Guadiana-Romualdo  7 , Jesper Eugen-Olsen  8 , Konstantinos Gourgoulianis  4 , Ioannis Pantazopoulos  9 ; SPARCOL Investigators
Collaborators, Affiliations
Observational Study

Circulating suPAR associates with severity and in-hospital progression of COVID-19

Athanasios Chalkias et al. Eur J Clin Invest. 2022 Jul.

Abstract

Background: COVID-19 disease progression is characterized by hyperinflammation and risk stratification may aid in early aggressive treatment and advanced planning. The aim of this study was to assess whether suPAR and other markers measured at hospital admission can predict the severity of COVID-19.

Methods: The primary outcome measure in this international, multi-centre, prospective, observational study with adult patients hospitalized primarily for COVID-19 was the association of WHO Clinical Progression Scale (WHO-CPS) with suPAR, ferritin, CRP, albumin, LDH, eGFR, age, procalcitonin, and interleukin-6. Admission plasma suPAR levels were determined using the suPARnostic® ELISA and suPARnostic® Turbilatex assays.

Results: Seven hundred and sixty-seven patients, 440 (57.4%) males and 327 (42.6%) females, were included with a median age of 64 years. Log-suPAR levels significantly correlated with WHO-CPS score, with each doubling of suPAR increasing the score by one point (p < .001). All the other markers were also correlated with WHO-CPS score. Admission suPAR levels were significantly lower in survivors (7.10 vs. 9.63, 95% CI 1.47-3.59, p < .001). A linear model (SALGA) including suPAR, serum albumin, serum lactate dehydrogenase, eGFR, and age can best estimate the WHO-CPS score and survival. Combining all five parameters in the SALGA model can improve the accuracy of discrimination with an AUC of 0.80 (95% CI: 0.759-0.836).

Conclusions: suPAR levels significantly correlated with WHO-CPS score, with each doubling of suPAR increasing the score by one point. The SALGA model may serve as a quick tool for predicting disease severity and survival at admission.

Keywords: COVID-19; WHO Clinical Progression Scale; outcome; suPAR.

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Conflict of interest statement

AC, AS, NP, EL, KT, AP, AM, NN, MM, DR, EBM, ICL, LGDGR, KG and IP report no conflicts of interest. JEO is a co‐founder, shareholder and CSO of ViroGates A/S and is mentioned inventor on patients on suPAR owned by Copenhagen University Hospital Hvidovre, Denmark.

Figures

FIGURE 1
FIGURE 1
Box plot of suPAR levels categorized by WHO COVID‐19 Outcome scale score
FIGURE 2
FIGURE 2
Receiver operating characteristic curves for prediction of survival after hospital admission. Different curves present the ability of five independent variables and their combined model to predict survival
FIGURE 3
FIGURE 3
Receiver operating characteristic curves for prediction of the need for supplemental oxygen therapy after hospital admission. Different curves present the ability of five independent variables and their combined model to predict the need of oxygen therapy
See this image and copyright information in PMC

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