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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...

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Autores principales: Besnier, Emmanuel, Brunel, Valéry, Thill, Caroline, Leprêtre, Perrine, Bellien, Jérémy, Demailly, Zoe, Renet, Sylvanie, Tamion, Fabienne, Clavier, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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