Presepsin in risk stratification of SARS-CoV-2 patients.

Zaninotto, Martina; Maria Mion, Monica; Cosma, Chiara; Rinaldi, Daniela; Plebani, Mario

BACKGROUND A severe form of pneumonia, is the leading complication of the respiratory Coronavirus disease 2019 (COVID-19), recently renamed SARS-CoV-2. Soluble cluster of differentiation (CD)14 subtype (sCD14-ST also termed presepsin PSP) is a regulatory factor that modulates immune responses by interacting with T and B cells, useful for early diagnosis, prognosis and risk stratification prediction. METHODS In 75 consecutive patients suffering from COVID-19 microbiology proven infection, admitted to intensive care unit (ICU, n=21, 28%) and/or in infectious disease ward (IW, n=54, 72%), PSP (Pathfast, Mitsubishi, Japan) has been measured in addition to routine laboratory tests performed during the period of hospitalization (from January to March 2020). RESULTS PSP demonstrates: -statistically significant higher values (Mann-Whitney test) in 6 patients died (median, IQR= 1046, 763-1240; vs 417, 281-678 ng/L, p<0.05); -statistically significant but poor correlations with CRP (r= 0.59 p<0.001), LDH (r=0.52, p<0.001) and PCT (r=0.72, p<0.001) measured at the same day; -a significant relationship between concentrations and ICU stay. In fact patients showing PSP values higher than 250 ng/L (cut-off for risk stratification) did stay in ICU for a significantly longer time (median 17 days, IQR 12-31; p<0.001) than those exhibiting lower values (median 10 days, IQR 7-18). CONCLUSIONS The data obtained seems to demonstrate the role of PSP in providing prognostic information in COVID-19 patients, allowing to identify, during the early phase of the monitoring, the patients suffering from a more severe disease which will be hospitalized for a more long time.