Soluble receptor for advanced glycation end products (sRAGE) as a biomarker of COVID-19 disease severity and indicator of the need for mechanical ventilation, ARDS and mortality.
Soluble receptor for advanced glycation end products (sRAGE) as a biomarker of COVID-19 disease severity and indicator of the need for mechanical ventilation, ARDS and mortality.
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DOI：
10.1186/s13613-021-00836-2
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发表时间：
2021-03-22
影响因子：
8.1
通讯作者：
Merle U
中科院分区：
文献类型：
--
作者：
Lim A;Radujkovic A;Weigand MA;Merle U
COVID-19肺炎和随后的呼吸衰竭正在给全球重症监护病房造成巨大压力。重症疾病的早期预测使临床医生能够避免急性呼吸窘迫综合征（ARDS）的发展，并改善危重患者的管理。晚期糖基化终产物可溶性受体是预测ARDS的生物标志物。尽管血清学水平因疾病类型而异，但有关COVID-19血清学水平变化的信息有限。因此，在COVID-19患者中测量了呼吸强度，以确定COVID-19严重程度的呼吸强度水平变化，并检查其预测COVID-19中机械通气（MV）需求和死亡率的能力。在德国的这项单中心观察性队列研究中，使用ELISA测量了急性COVID-19期间、COVID-19症状开始后20周以及非COVID-19肺炎患者和健康对照的对照组中的血清胆红素。主要终点为重度疾病（高流量鼻氧治疗（HFNO）/MV和器官支持需求）。次要终点是需要MV的呼吸衰竭和30天死亡率。计算曲线下面积（AUC）、基于Youden指数的截断值和相对比值比（95%CI），以预测MV需求和死亡率。对164名COVID-19患者、101名匹配的COVID-19恢复期患者、23名非COVID-19肺炎患者和15名健康志愿者进行了血清sIgA测定。随着COVID-19严重程度、氧疗需求、HFNO/MV、ARDS严重程度、透析和儿茶酚胺支持需求、30天死亡率、序贯器官衰竭评估（SOFA）和快速SOFA（qSOFA）评分的增加，severity水平升高。研究发现，severity是COVID-19住院患者MV需求和死亡率的良好预测因子，AUC分别为0.871（0.770 - 0.973）和0.903（0.817 - 0.990）。当调整男性性别、年龄、合并症和SOFA评分≥ 3时，severity与HFNO/MV需求风险独立相关。当调整SOFA评分≥ 3时，severity与需要MV的风险独立相关。随着疾病严重程度的增加，COVID-19患者的血清胰岛素浓度升高。应将血清学视为预测COVID-19中MV需求和死亡率的生物标志物。在线版本包含补充材料，可通过10.1186/s13613 - 021 - 00836 - 2获得。
COVID-19 pneumonia and subsequent respiratory failure is causing an immense strain on intensive care units globally. Early prediction of severe disease enables clinicians to avoid acute respiratory distress syndrome (ARDS) development and improve management of critically ill patients. The soluble receptor of advanced glycation endproducts (sRAGE) is a biomarker shown to predict ARDS. Although sRAGE level varies depending on the type of disease, there is limited information available on changes in sRAGE levels in COVID-19. Therefore, sRAGE was measured in COVID-19 patients to determine sRAGE level variation in COVID-19 severity and to examine its ability to predict the need for mechanical ventilation (MV) and mortality in COVID-19. In this single-centre observational cohort study in Germany, serum sRAGE during acute COVID-19, 20 weeks after the start of COVID-19 symptoms, as well as in control groups of non-COVID-19 pneumonia patients and healthy controls were measured using ELISA. The primary endpoint was severe disease (high-flow nasal oxygen therapy (HFNO)/MV and need of organ support). The secondary endpoints were respiratory failure with need of MV and 30-day mortality. The area under the curve (AUC), cut-off based on Youden’s index and odds ratio with 95% CI for sRAGE were calculated with regard to prediction of MV need and mortality. Serum sRAGE in 164 COVID-19 patients, 101 matched COVID-19 convalescent patients, 23 non-COVID-19 pneumonia patients and 15 healthy volunteers were measured. sRAGE level increased with COVID-19 severity, need for oxygen therapy, HFNO/MV, ARDS severity, need of dialysis and catecholamine support, 30-day mortality, sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) score. sRAGE was found to be a good predictor of MV need in COVID-19 inpatients and mortality with an AUC of 0.871 (0.770–0.973) and 0.903 (0.817–0.990), respectively. When adjusted for male gender, age, comorbidity and SOFA score ≥ 3, sRAGE was independently associated with risk of need for HFNO/MV. When adjusted for SOFA score ≥ 3, sRAGE was independently associated with risk of need for MV. Serum sRAGE concentrations are elevated in COVID-19 patients as disease severity increases. sRAGE should be considered as a biomarker for predicting the need for MV and mortality in COVID-19. The online version contains supplementary material available at 10.1186/s13613-021-00836-2.
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影响因子：
2.2
作者：
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