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Predictive performa...
Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection : a prospective multicentre cohort study
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- Staessen, Jan A. (författare)
- Non-Profit Research Institute Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium; Biomedical Sciences Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
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- Wendt, Ralph (författare)
- Department of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany
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- Yu, Yu-Ling (författare)
- Research Unit Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
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- Kalbitz, Sven (författare)
- Department of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany
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- Thijs, Lutgarde (författare)
- Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
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- Siwy, Justyna (författare)
- Mosaiques-Diagnostics, Hannover, Germany
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- Raad, Julia (författare)
- Mosaiques-Diagnostics, Hannover, Germany
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- Metzger, Jochen (författare)
- Mosaiques-Diagnostics, Hannover, Germany
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- Neuhaus, Barbara (författare)
- Centre for Clinical Trials, Medizinische Hochschule, Hannover, Germany
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- Papkalla, Armin (författare)
- Centre for Clinical Trials, Medizinische Hochschule, Hannover, Germany
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- von der Leyen, Heiko (författare)
- Centre for Clinical Trials, Medizinische Hochschule, Hannover, Germany
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- Mebazaa, Alexandre (författare)
- Department of Anaesthesiology and Intensive Care, Hospital Saint Louis-Lariboisière, Paris, France
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- Dudoignon, Emmanuel (författare)
- Department of Anaesthesiology and Intensive Care, Hospital Saint Louis-Lariboisière, Paris, France
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- Spasovski, Goce (författare)
- Cyril and Methodius University, Skopje, North Macedonia
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- Milenkova, Mimoza (författare)
- Cyril and Methodius University, Skopje, North Macedonia
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- Canevska-Taneska, Aleksandra (författare)
- Cyril and Methodius University, Skopje, North Macedonia
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- Salgueira Lazo, Mercedes (författare)
- Hospital Virgen Macarena, Sevilla, Spain
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- Psichogiou, Mina (författare)
- First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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- Rajzer, Marek W. (författare)
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
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- Fuławka, Łukasz (författare)
- Molecular Pathology Centre Cellgen, Wrocław, Poland
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- Dzitkowska-Zabielska, Magdalena (författare)
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport and Centre of Translational Medicine, Medical University of Gdańsk, Gdańsk, Poland
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- Weiss, Guenter (författare)
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
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- Feldt, Torsten (författare)
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
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- Stegemann, Miriam (författare)
- Department of Infectious Diseases and Respiratory Medicine, Charité Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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- Normark, Johan (författare)
- Umeå universitet,Institutionen för klinisk mikrobiologi,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)
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- Zoufaly, Alexander (författare)
- Department of Medicine IV, Clinic Favoriten and Faculty of Medicine, Sigmund Freud University, Vienna, Austria
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- Schmiedel, Stefan (författare)
- Medical Department I and Bernhard-Nocht-Clinic for Tropical Medicine, University Medical Centre Hamburg Eppendorf, Hamburg, Germany
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- Seilmaier, Michael (författare)
- Department of Haematology, Oncology, Immunology, Palliative Care, Infectious Disease and Tropical Medicine, München Klinik Schwabing, München, Germany
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- Rumpf, Benedikt (författare)
- Nephrology and Dialysis, Internal Medicine III, Medical University of Vienna, Vienna, Austria
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- Banasik, Mirosław (författare)
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland
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- Krajewska, Magdalena (författare)
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland
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- Catanese, Lorenzo (författare)
- Department of Nephrology, Angiology and Rheumatology, Hospital Bayreuth, Bayreuth, Germany
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- Rupprecht, Harald D. (författare)
- Department of Nephrology, Angiology and Rheumatology, Hospital Bayreuth, Bayreuth, Germany
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- Czerwieńska, Beata (författare)
- University of Silesia, Katowice, Poland
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- Peters, Björn (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Nilsson, Åsa (författare)
- Research and Development Centre, Skaraborg Hospital, Skövde, Sweden
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- Rothfuss, Katja (författare)
- Department of Gastroenterology, Hepatology and Endocrinology, Robert Bosch Hospital, Stuttgart, Germany
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- Lübbert, Christoph (författare)
- Department of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany; Division of Infectious Diseases and Tropical Medicine, Leipzig University Medical Centre, Leipzig, Germany
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- Mischak, Harald (författare)
- Mosaiques-Diagnostics, Hannover, Germany; Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom
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- Beige, Joachim (författare)
- Department of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle an der Saale, Halle, Germany
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- Engelska.
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Ingår i: The Lancet Digital Health. - : Elsevier. - 2589-7500. ; 4:10, s. e727-e737
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
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- Background: The SARS-CoV-2 pandemic is a worldwide challenge. The CRIT-CoV-U pilot study generated a urinary proteomic biomarker consisting of 50 peptides (COV50), which predicted death and disease progression from SARS-CoV-2. After the interim analysis presented for the German Government, here, we aimed to analyse the full dataset to consolidate the findings and propose potential clinical applications of this biomarker.Methods: CRIT-CoV-U was a prospective multicentre cohort study. In eight European countries (Austria, France, Germany, Greece, North Macedonia, Poland, Spain, and Sweden), 1012 adults with PCR-confirmed COVID-19 were followed up for death and progression along the 8-point WHO scale. Capillary electrophoresis coupled with mass spectrometry was used for urinary proteomic profiling. Statistical methods included logistic regression and receiver operating characteristic curve analysis with a comparison of the area under curve (AUC) between nested models. Hospitalisation costs were derived from the care facility corresponding with the Markov chain probability of reaching WHO scores ranging from 3 to 8 and flat-rate hospitalisation costs adjusted for the gross per capita domestic product of each country.Findings: From June 30 to Nov 19, 2020, 228 participants were recruited, and from April 30, 2020, to April 14, 2021, 784 participants were recruited, resulting in a total of 1012 participants. The entry WHO scores were 1–3 in 445 (44%) participants, 4–5 in 529 (52%) participants, and 6 in 38 (4%) participants; and of all participants, 119 died and 271 had disease progression. The odds ratio (OR) associated with COV50 in all 1012 participants for death was 2·44 (95% CI 2·05–2·92) unadjusted and 1·67 (1·34–2·07) when adjusted for sex, age, BMI, comorbidities, and baseline WHO score; and for disease progression, the OR was 1·79 (1·60–2·01) when unadjusted and 1·63 (1·41–1·91) when adjusted (p<0·0001 for all). The predictive accuracy of the optimised COV50 thresholds was 74·4% (71·6–77·1%) for mortality (threshold 0·47) and 67·4% (64·4–70·3%) for disease progression (threshold 0·04). When adjusted for covariables and the baseline WHO score, these thresholds improved AUCs from 0·835 to 0·853 (p=0·033) for death and from 0·697 to 0·730 (p=0·0008) for progression. Of 196 participants who received ambulatory care, 194 (99%) did not reach the 0·04 threshold. The cost reductions associated with 1 day less hospitalisation per 1000 participants were million Euro (M€) 0·887 (5–95% percentile interval 0·730–1·039) in participants at a low risk (COV50 <0·04) and M€2·098 (1·839-2·365) in participants at a high risk (COV50 ≥0·04).Interpretation: The urinary proteomic COV50 marker might be predictive of adverse COVID-19 outcomes. Even in people with mild-to-moderate PCR-confirmed infections (WHO scores 1–4), the 0·04 COV50 threshold justifies earlier drug treatment, thereby potentially reducing the number of days in hospital and associated costs. Funding: German Federal Ministry of Health.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
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Staessen, Jan A.
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Wendt, Ralph
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Yu, Yu-Ling
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Kalbitz, Sven
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Thijs, Lutgarde
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Siwy, Justyna
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Raad, Julia
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Metzger, Jochen
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Neuhaus, Barbara
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Papkalla, Armin
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von der Leyen, H ...
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Mebazaa, Alexand ...
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Dudoignon, Emman ...
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Spasovski, Goce
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Milenkova, Mimoz ...
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Canevska-Taneska ...
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Salgueira Lazo, ...
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Psichogiou, Mina
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Rajzer, Marek W.
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Fuławka, Łukasz
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Dzitkowska-Zabie ...
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Weiss, Guenter
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Feldt, Torsten
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Stegemann, Miria ...
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Normark, Johan
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Zoufaly, Alexand ...
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Schmiedel, Stefa ...
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Seilmaier, Micha ...
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Rumpf, Benedikt
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Banasik, Mirosła ...
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Krajewska, Magda ...
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Catanese, Lorenz ...
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Rupprecht, Haral ...
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Czerwieńska, Bea ...
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Peters, Björn
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Nilsson, Åsa
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Rothfuss, Katja
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Lübbert, Christo ...
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Mischak, Harald
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Beige, Joachim
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Urologi och njur ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Hälsovetenskap
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och Folkhälsovetensk ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Infektionsmedici ...
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The Lancet Digit ...
- Av lärosätet
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Umeå universitet
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Göteborgs universitet