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  • Staessen, Jan A.Non-Profit Research Institute Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium; Biomedical Sciences Group, Faculty of Medicine, University of Leuven, Leuven, Belgium (författare)

Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection : a prospective multicentre cohort study

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • Elsevier,2022
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:umu-199891
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-199891URI
  • https://doi.org/10.1016/S2589-7500(22)00150-9DOI
  • https://gup.ub.gu.se/publication/318216URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • 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 och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Wendt, RalphDepartment of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany (författare)
  • Yu, Yu-LingResearch Unit Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium (författare)
  • Kalbitz, SvenDepartment of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany (författare)
  • Thijs, LutgardeResearch Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium (författare)
  • Siwy, JustynaMosaiques-Diagnostics, Hannover, Germany (författare)
  • Raad, JuliaMosaiques-Diagnostics, Hannover, Germany (författare)
  • Metzger, JochenMosaiques-Diagnostics, Hannover, Germany (författare)
  • Neuhaus, BarbaraCentre for Clinical Trials, Medizinische Hochschule, Hannover, Germany (författare)
  • Papkalla, ArminCentre for Clinical Trials, Medizinische Hochschule, Hannover, Germany (författare)
  • von der Leyen, HeikoCentre for Clinical Trials, Medizinische Hochschule, Hannover, Germany (författare)
  • Mebazaa, AlexandreDepartment of Anaesthesiology and Intensive Care, Hospital Saint Louis-Lariboisière, Paris, France (författare)
  • Dudoignon, EmmanuelDepartment of Anaesthesiology and Intensive Care, Hospital Saint Louis-Lariboisière, Paris, France (författare)
  • Spasovski, GoceCyril and Methodius University, Skopje, North Macedonia (författare)
  • Milenkova, MimozaCyril and Methodius University, Skopje, North Macedonia (författare)
  • Canevska-Taneska, AleksandraCyril and Methodius University, Skopje, North Macedonia (författare)
  • Salgueira Lazo, MercedesHospital Virgen Macarena, Sevilla, Spain (författare)
  • Psichogiou, MinaFirst Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece (författare)
  • Rajzer, Marek W.First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland (författare)
  • Fuławka, ŁukaszMolecular Pathology Centre Cellgen, Wrocław, Poland (författare)
  • Dzitkowska-Zabielska, MagdalenaFaculty of Physical Education, Gdańsk University of Physical Education and Sport and Centre of Translational Medicine, Medical University of Gdańsk, Gdańsk, Poland (författare)
  • Weiss, GuenterDepartment of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria (författare)
  • Feldt, TorstenDepartment of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany (författare)
  • Stegemann, MiriamDepartment of Infectious Diseases and Respiratory Medicine, Charité Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany (författare)
  • Normark, JohanUmeå universitet,Institutionen för klinisk mikrobiologi,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)(Swepub:umu)jono0053 (författare)
  • Zoufaly, AlexanderDepartment of Medicine IV, Clinic Favoriten and Faculty of Medicine, Sigmund Freud University, Vienna, Austria (författare)
  • Schmiedel, StefanMedical Department I and Bernhard-Nocht-Clinic for Tropical Medicine, University Medical Centre Hamburg Eppendorf, Hamburg, Germany (författare)
  • Seilmaier, MichaelDepartment of Haematology, Oncology, Immunology, Palliative Care, Infectious Disease and Tropical Medicine, München Klinik Schwabing, München, Germany (författare)
  • Rumpf, BenediktNephrology and Dialysis, Internal Medicine III, Medical University of Vienna, Vienna, Austria (författare)
  • Banasik, MirosławDepartment of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland (författare)
  • Krajewska, MagdalenaDepartment of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland (författare)
  • Catanese, LorenzoDepartment of Nephrology, Angiology and Rheumatology, Hospital Bayreuth, Bayreuth, Germany (författare)
  • Rupprecht, Harald D.Department of Nephrology, Angiology and Rheumatology, Hospital Bayreuth, Bayreuth, Germany (författare)
  • Czerwieńska, BeataUniversity of Silesia, Katowice, Poland (författare)
  • Peters, BjörnGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xpebjo (författare)
  • Nilsson, ÅsaResearch and Development Centre, Skaraborg Hospital, Skövde, Sweden (författare)
  • Rothfuss, KatjaDepartment of Gastroenterology, Hepatology and Endocrinology, Robert Bosch Hospital, Stuttgart, Germany (författare)
  • Lübbert, ChristophDepartment 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 (författare)
  • Mischak, HaraldMosaiques-Diagnostics, Hannover, Germany; Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom (författare)
  • Beige, JoachimDepartment 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 (författare)
  • Non-Profit Research Institute Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium; Biomedical Sciences Group, Faculty of Medicine, University of Leuven, Leuven, BelgiumDepartment of Infectious Diseases and Tropical Medicine, Nephrology and Kuratorium für Dialyse und Nierentransplantation Renal Unit and Rheumatology, St Georg Hospital, Leipzig, Germany (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:The Lancet Digital Health: Elsevier4:10, s. e727-e7372589-7500

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