Elevated level of serum human epididymis protein 4 (HE4) predicts disease severity and mortality in COVID-19 pneumonia

Background We retrospectively analyzed serum level of human epididymis protein 4 (HE4) as a pulmonary inflammatory biomarker in patients with COVID-19 pneumonia in association with disease severity and outcome. Methods Ninety-nine (40 critically ill, 40 severe and 19 mild) COVID-19 patients and as controls 25 age- and sex-matched non-COVID-19 bacterial sepsis subjects were included. Serum HE4 was measured by an immunoassay ($ Architect^{®} $ i1000SR, Abbott) in the baseline samples of all study participants obtained at intensive care unit (ICU) admission or during outpatient clinic visit and follow-up sera were available in case of 30 COVID-19 subjects with life-threating conditions. Associations were studied between serum HE4, routinely available laboratory parameters, clinical characteristics, and disease progression. Results Baseline HE4 level was significantly higher (P < 0.0001) in critically ill (524.7 [300.1–1153.0] pmol/L) than severe COVID-19 subjects (157.4 [85.2-336.9] pmol/L) and in mild SARS-CoV-2 infection (46.7 [39.1–57.2] pmol/L). Similarly increased HE4 concentrations were found in bacterial sepsis (1118.0 [418.3–1953.0] pmol/L, P = 0.056) compared to critically ill COVID-19 individuals. Serum HE4 levels significantly correlated with age, SOFA-score, inflammation-dependent biomarkers, and the degree of lung manifestation evaluated by chest CT examination in ICU COVID-19 individuals. Based on ROC-AUC curve analysis, baseline HE4 independently indicated the severity of COVID-19 with an AUC value of 0.816 (95% CI [0.723–0.908]; P < 0.0001), while binary logistic regression test found HE4 as an independent prognostic parameter for death (OR: 10.618 [2.331–48.354]; P = 0.002). Furthermore, COVID-19 non-survivors showed much higher baseline HE4 levels without a substantial change under treatment vs. survivors (P < 0.0001). Finally, pre-treatment HE4 level of ≥ 331.7 pmol/L effectively predicted a larger risk for mortality (Log-Rank P < 0.0001) due to severe COVID-19 pneumonia. Conclusion Elevated serum HE4 level at ICU admission highly correlates with COVID-19 severity and predicts disease outcome..

Medienart:	E-Artikel

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Zur Gesamtaufnahme - volume:23
Enthalten in:	BMC pulmonary medicine - 23(2023), 1 vom: 16. Dez.

Sprache:	Englisch

Beteiligte Personen:	Sütő, Renáta [VerfasserIn] Pócsi, Marianna [VerfasserIn] Szabó, Zsolt [VerfasserIn] Fejes, Zsolt [VerfasserIn] Ivády, Gergely [VerfasserIn] Kerekes, György [VerfasserIn] Fagyas, Miklós [VerfasserIn] Nagy, Attila [VerfasserIn] Szentkereszty, Zoltán [VerfasserIn] Kappelmayer, János [VerfasserIn] Nagy, Béla [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	Biomarker COVID-19 Disease HE4 Inflammation Outcome Pneumonia SARS-CoV-2

Anmerkungen:	© The Author(s) 2023

doi:	10.1186/s12890-023-02811-y

funding:
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PPN (Katalog-ID):	SPR054112311