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Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study
Background: The different waves of SARS-CoV-2 infection have strained hospital resources and, notably, intensive care units (ICUs). Identifying patients at risk of developing a critical condition is essential to correctly refer patients to the appropriate structure and to spare limited resources. Th...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369719/ https://www.ncbi.nlm.nih.gov/pubmed/35956186 http://dx.doi.org/10.3390/jcm11154571 |
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author | Besnier, Emmanuel Brunel, Valéry Thill, Caroline Leprêtre, Perrine Bellien, Jérémy Demailly, Zoe Renet, Sylvanie Tamion, Fabienne Clavier, Thomas |
author_facet | Besnier, Emmanuel Brunel, Valéry Thill, Caroline Leprêtre, Perrine Bellien, Jérémy Demailly, Zoe Renet, Sylvanie Tamion, Fabienne Clavier, Thomas |
author_sort | Besnier, Emmanuel |
collection | PubMed |
description | Background: The different waves of SARS-CoV-2 infection have strained hospital resources and, notably, intensive care units (ICUs). Identifying patients at risk of developing a critical condition is essential to correctly refer patients to the appropriate structure and to spare limited resources. The soluble form of RAGE (sRAGE), the endoplasmic stress response and its surrogates, GRP78 and VEGF-A, may be interesting markers. Methods: This was a prospective monocenter cohort study of adult patients admitted to the ICU for severe COVID-19 pneumonia. The plasma levels of sRAGE, GRP78 and VEGF-A were measured within the first 24 h. Patients were classified as critical if they further needed vasopressor therapy, renal replacement therapy, or invasive mechanical ventilation, or died during their ICU stay, and were otherwise classified as not critical. Results: A total of 98 patients were included and 39 developed a critical condition. Critical patients presented higher sRAGE (626 [450–1043] vs. 227 [137–404] pg/mL, p < 0.0001), interleukin-6 (43 [15–112] vs. 11 [5–20] pg/mL, p < 0.0001), troponin T (17 [9–39] vs. 10 [6–18] pg/mL, p = 0.003) and NT-pro-BNP (321 [118–446] vs. 169 [63–366] pg/mL, p = 0.009) plasma levels. No difference was observed for VEGF-A and GRP78. The variables independently associated with worsening in the ICU were sRAGE (1.03 [1.01–1.05] per 10 pg/mL) and age (1.7 [1.2–2.4] per 5 years). An sRAGE value of 449.5 pg/mL predicted worsening with a sensitivity of 77% and a specificity of 80%. Conclusion: sRAGE may allow the identification of patients at risk of developing a critical form of COVID-19 pneumonia, and thus may be useful to correctly refer patients to the appropriate structure of care. |
format | Online Article Text |
id | pubmed-9369719 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93697192022-08-12 Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study Besnier, Emmanuel Brunel, Valéry Thill, Caroline Leprêtre, Perrine Bellien, Jérémy Demailly, Zoe Renet, Sylvanie Tamion, Fabienne Clavier, Thomas J Clin Med Article Background: The different waves of SARS-CoV-2 infection have strained hospital resources and, notably, intensive care units (ICUs). Identifying patients at risk of developing a critical condition is essential to correctly refer patients to the appropriate structure and to spare limited resources. The soluble form of RAGE (sRAGE), the endoplasmic stress response and its surrogates, GRP78 and VEGF-A, may be interesting markers. Methods: This was a prospective monocenter cohort study of adult patients admitted to the ICU for severe COVID-19 pneumonia. The plasma levels of sRAGE, GRP78 and VEGF-A were measured within the first 24 h. Patients were classified as critical if they further needed vasopressor therapy, renal replacement therapy, or invasive mechanical ventilation, or died during their ICU stay, and were otherwise classified as not critical. Results: A total of 98 patients were included and 39 developed a critical condition. Critical patients presented higher sRAGE (626 [450–1043] vs. 227 [137–404] pg/mL, p < 0.0001), interleukin-6 (43 [15–112] vs. 11 [5–20] pg/mL, p < 0.0001), troponin T (17 [9–39] vs. 10 [6–18] pg/mL, p = 0.003) and NT-pro-BNP (321 [118–446] vs. 169 [63–366] pg/mL, p = 0.009) plasma levels. No difference was observed for VEGF-A and GRP78. The variables independently associated with worsening in the ICU were sRAGE (1.03 [1.01–1.05] per 10 pg/mL) and age (1.7 [1.2–2.4] per 5 years). An sRAGE value of 449.5 pg/mL predicted worsening with a sensitivity of 77% and a specificity of 80%. Conclusion: sRAGE may allow the identification of patients at risk of developing a critical form of COVID-19 pneumonia, and thus may be useful to correctly refer patients to the appropriate structure of care. MDPI 2022-08-05 /pmc/articles/PMC9369719/ /pubmed/35956186 http://dx.doi.org/10.3390/jcm11154571 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Besnier, Emmanuel Brunel, Valéry Thill, Caroline Leprêtre, Perrine Bellien, Jérémy Demailly, Zoe Renet, Sylvanie Tamion, Fabienne Clavier, Thomas Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study |
title | Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study |
title_full | Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study |
title_fullStr | Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study |
title_full_unstemmed | Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study |
title_short | Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study |
title_sort | soluble rage as a prognostic marker of worsening in patients admitted to the icu for covid-19 pneumonia: a prospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369719/ https://www.ncbi.nlm.nih.gov/pubmed/35956186 http://dx.doi.org/10.3390/jcm11154571 |
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