Pentraxin-3 (PTX-3) as a potential biomarker for predicting death in hospitalized patients with COVID-19.

IF 4 3区 医学 Q2 VIROLOGY Virology Journal Pub Date : 2024-09-27 DOI:10.1186/s12985-024-02501-z
Milena Xavier Silva Barbosa, Anderson da Costa Armstrong, Carlos Dornels Freire de Souza, Rodrigo Feliciano do Carmo
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Abstract

Background: Pentraxin 3 (PTX3) is an acute-phase protein that belongs to the pentraxin family, which plays an important role in the body's defense against pathogens. PTX3 levels have been associated with inflammatory processes, and it is a possible biomarker for the diagnosis and prognosis of different infectious diseases, including COVID-19. The objective of this study was to analyze the potential of PTX3 as a plasma biomarker for predicting death in patients hospitalized with COVID-19.

Methods: The study included a total of 312 patients with COVID-19, admitted from July 2020 to August 2021 to hospital ward and intensive care unit beds at two hospitals in the Northeast Region of Brazil. PTX3 was measured using ELISA in samples collected within 24 h after hospital admission. Maximally selected rank statistics were used to determine the PTX3 cutoff point that best distinguished patients who died from those who survived. A receiver operating characteristic (ROC) curve was used to determine the performance of the biomarker. Survival analysis was performed using a Kaplan-Meier curve, and a Cox regression model was used to determine predictors associated with death.

Results: Of the 312 patients included in the study, 233 recovered and 79 died. Patients who died had higher PTX3 levels at the time of admission, when compared to those who recovered (median: 52.84 versus 10.79 ng/mL; p < 0.001). PTX3 showed area under the ROC (AUC) = 0.834, higher than other markers used in clinical practice, such as C-reactive protein (AUC = 0.72) and D-dimer (AUC = 0.77). Furthermore, according to the Kaplan-Meier survival curve, patients with PTX3 concentrations above the cutoff point (27.3 ng/mL) had a lower survival rate (p = 0.014). In multivariate Cox regression, PTX3 > 27.3 ng/mL was an important predictor of death, regardless of other confounding factors (hazard ratio = 1.79; p = 0.027).

Conclusion: PTX3 can be considered as a potential biomarker for predicting death in patients hospitalized with COVID-19.

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五肽-3(PTX-3)是预测 COVID-19 住院患者死亡的潜在生物标志物。
背景:五肽 3(PTX3)是一种急性期蛋白,属于五肽家族,在机体抵御病原体的过程中发挥着重要作用。PTX3 的水平与炎症过程有关,是诊断和预后不同感染性疾病(包括 COVID-19)的可能生物标志物。本研究旨在分析 PTX3 作为血浆生物标志物预测 COVID-19 住院患者死亡的潜力:研究对象包括2020年7月至2021年8月期间入住巴西东北部地区两家医院病房和重症监护室病床的312名COVID-19患者。采用酶联免疫吸附法测定入院后24小时内采集的样本中的PTX3。使用最大选择秩统计来确定最能区分死亡和存活患者的 PTX3 临界点。接收者操作特征(ROC)曲线用于确定生物标记物的性能。使用 Kaplan-Meier 曲线进行生存分析,并使用 Cox 回归模型确定与死亡相关的预测因素:结果:在312名参与研究的患者中,233人康复,79人死亡。与康复患者相比,死亡患者入院时的 PTX3 水平较高(中位数为 52.84,死亡患者为 10.79 ng):中位数:52.84 ng/mL 对 10.79 ng/mL; p 27.3 ng/mL是预测死亡的重要因素,与其他混杂因素无关(危险比 = 1.79; p = 0.027):PTX3可被视为预测COVID-19住院患者死亡的潜在生物标志物。
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来源期刊
Virology Journal
Virology Journal 医学-病毒学
CiteScore
7.40
自引率
2.10%
发文量
186
审稿时长
1 months
期刊介绍: Virology Journal is an open access, peer reviewed journal that considers articles on all aspects of virology, including research on the viruses of animals, plants and microbes. The journal welcomes basic research as well as pre-clinical and clinical studies of novel diagnostic tools, vaccines and anti-viral therapies. The Editorial policy of Virology Journal is to publish all research which is assessed by peer reviewers to be a coherent and sound addition to the scientific literature, and puts less emphasis on interest levels or perceived impact.
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