| Autor: |
Eran Eden, Michal Rosenberg, Michal Stein, Shaul Lev, Guy Danziger, Tanya M. Gottlieb, Pierre Singer, Einav Simon, Amir Jarjoui, Tahel Ilan Ber, Oded Shaham, Sergey Motov, Mary Hainrichson, Yael Israeli, Paul D. Feigin, Ma'anit Shapira, Ilya Kagan, Dror Diker, Noa Avni, Eli Ben-Chetrit, Boaz Tadmor, Ramzi Kurd, Eran Reiner, Cihan Papan, Adi Klein, Alon Angel, Niv Mastboim, Roy Navon, Kfir Oved |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
medRxiv |
| DOI: |
10.1101/2021.06.27.21259196 |
| Popis: |
BACKGROUNDAccurately identifying COVID-19 patients at-risk to deteriorate remains challenging. Tools integrating host-protein expression have proven useful in determining infection etiology and hold potential for prognosticating disease severity.METHODSAdults with COVID-19 were recruited at medical centers in Israel, Germany, and the United States. Severe outcome was defined as intensive care unit admission, non-invasive or invasive ventilation, or death. Tumor necrosis factor related apoptosis inducing ligand (TRAIL) and interferon gamma inducible protein-10 (IP-10; also known as CXCL10) and C-reactive protein (CRP) were measured using an analyzer providing values within 15 minutes. A signature indicating the likelihood of severe outcome was derived generating a score (0-100). Patients were assigned to 4 score bins.RESULTSBetween March and November 2020, 518 COVID-19 patients were enrolled, of whom 394 were eligible, 29% meeting a severe outcome. The signature’s area under the receiver operating characteristic curve (AUC) was 0.86 (95% confidence interval: 0.81-0.91). Performance was not confounded by age, sex, or comorbidities and superior to IL-6 (AUC 0.77; p = 0.033) and CRP (AUC 0.78; p < 0.001). Likelihood of severe outcome increased significantly (p < 0.001) with higher scores. The signature differentiated patients who further deteriorated after meeting a severe outcome from those who improved (p = 0.004) and projected 14-day survival probabilities (p < 0.001).CONCLUSIONThe derived immune-protein signature combined with a rapid measurement platform is an accurate predictive tool for early detection of COVID-19 patients at-risk for severe outcome, facilitating timely care escalation and de-escalation and appropriate resource allocation.FUNDINGMeMed funded the study |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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