Presepsin as a Novel Biomarker in predicting Inhospital Mortality in COVID-19 Pneumonia Patients

Abstract

Objectives

Different biomarkers such as CRP, serum ferritin and D dimer are used in prognostic assessment of patients with COVID-19 pneumonia. Presepsin(PSP) is a soluble CD14 subtype has recently been proposed as a novel biomarker in sepsis patients. The aim of the current study was to detect the relation of presepsin to the outcome of COVID-19 as well as its relation to other inflammatory biomarkers.

Methods

Multicenter, retrospective observational study was conducted in Saudi Arabia and Misr International Hospital, Egypt from January 2021 to May 2021. Hospitalized patients who had positive throat swab of SARS-COV2 and radiological evidence of viral pneumonia (moderate and severe forms) were included in the study. Demographics and clinical features, as well as laboratory parameters including serum ferritin, CRP, D-dimer, presepsin of enrolled patients were retrospectively collected. Pneumonia severity index (PSI) was used to evaluate the severity of pneumonia.

Results

202 hospitalized patients were diagnosed with COVID-19 pneumonia and had positive results of SARS-CoV-2 RNA; were enrolled to our study. Out of 202 hospitalized patients 67 patients (33.17%) required ICU admission. One hundred seventy-six (87.1%) patients survived and were discharged, 26 (12.9%) patients didn't survive. Presepsin level was found to be significantly elevated in non-survivor versus survivor group, median (IQR),978.5(755.8-1400) vs 516.5(343.3-720), p<0.001 as well in ICU versus non-ICU patients, median (IQR), 800(631-1200) and 446(320-626), respectively (P value<0.001). Elevated levels were also found to be associated with increase length of hospital stay. Levels above 775 pg/ml were found to be associated with in-hospital mortality specificity 80%, sensitivity 73%.

Conclusion

Elevated presepsin levels indicated poor outcomes in hospitalized COVID-19 pneumonia and was associated with in-hospital mortality.