Soluble TREM-1 plasma concentration predicts poor outcome in COVID-19 patients.

Autor: Gibot, Sébastien, Lafon, Thomas, Jacquin, Laurent, Lefevre, Benjamin, Kimmoun, Antoine, Guillaumot, Anne, Losser, Marie-Reine, Douplat, Marion, Argaud, Laurent, De Ciancio, Guillaume, Jolly, Lucie, Touly, Nina, Derive, Marc, Malaplate, Catherine, Luc, Amandine, Baumann, Cédric, François, Bruno
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Zdroj: Intensive Care Medicine Experimental; 8/14/2023, Vol. 11 Issue 1, p1-11, 11p
Abstrakt: Background: The immuno-receptor Triggering Expressed on Myeloid cells-1 (TREM-1) is activated during bacterial infectious diseases, where it amplifies the inflammatory response. Small studies suggest that TREM-1 could be involved in viral infections, including COVID-19. We here aim to decipher whether plasma concentration of the soluble form of TREM-1 (sTREM-1) could predict the outcome of hospitalized COVID-19 patients. Methods: We conducted a multicentre prospective observational study in 3 university hospitals in France. Consecutive hospitalized patients with confirmed infection with SARS-CoV-2 were enrolled. Plasma concentration of sTREM-1 was measured on admission and then at days 4, 6, 8, 14, 21, and 28 in patients admitted into an ICU (ICU cohort: ICUC) or 3 times a week for patients hospitalized in a medical ward (Conventional Cohort: ConvC). Clinical and biological data were prospectively recorded and patients were followed-up for 90 days. For medical ward patients, the outcome was deemed complicated in case of requirement of increased oxygen supply > 5 L/min, transfer to an ICU, or death. For Intensive Care Unit (ICU) patients, complicated outcome was defined by death in the ICU. Results: Plasma concentration of sTREM-1 at inclusion was higher in ICU patients (n = 269) than in medical ward patients (n = 562) (224 pg/mL (IQR 144–320) vs 147 pg/mL (76–249), p < 0.0001), and higher in patients with a complicated outcome in both cohorts: 178 (94–300) vs 135 pg/mL (70–220), p < 0.0001 in the ward patients, and 342 (288–532) vs 206 pg/mL (134–291), p < 0.0001 in the ICU patients. Elevated sTREM-1 baseline concentration was an independent predictor of complicated outcomes (Hazard Ratio (HR) = 1.5 (1.1–2.1), p = 0.02 in ward patients; HR = 3.8 (1.8–8.0), p = 0.0003 in ICU patients). An sTREM-1 plasma concentration of 224 pg/mL had a sensitivity of 42%, and a specificity of 76% in the ConvC for complicated outcome. In the ICUC, a 287 pg/mL cutoff had a sensitivity of 78%, and a specificity of 74% for death. The sTREM-1 concentrations increased over time in the ConvC patients with a complicated outcome (p = 0.017), but not in the ICUC patients. Conclusions: In COVID-19 patients, plasma concentration of sTREM-1 is an independent predictor of the outcome, although its positive and negative likelihood ratio are not good enough to guide clinical decision as a standalone marker. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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