Selçuk YAYLACI, Hamad DHEİR, Ahmed Cihad GENÇ, Kubilay İŞSEVER, Deniz ÇEKİÇ, Ahmed Bilal GENÇ, Havva KOCAYİĞİT, Erdem ÇOKLUK, Mehmet Ramazan ŞEKEROĞLU, Hande TOPTAN ÇAKAR, Ertuğrul GÜÇLÜ, Alper KARACAN

The predictive and diagnostic accuracy of long pentraxin-3 in COVID-19 pneumonia

Background/aim: The purpose of this study is to evaluate serum pentraxin-3 (PTX-3) levels in Sars-CoV-2 virus infection (COVID-19) patients and to investigate whether PTX-3 predicts the disease prognosis. Materials and methods: This study was conducted on 88 confirmed COVID-19 patients who were hospitalized due to symptomatic pneumonia between April 15 and August 15, 2020. The patients were divided into two groups as survived patients and non-survived patients. Both groups were compared according to demographic features, comorbid conditions and measurement of the PTX-3 and other laboratory parameters of the patients. Results: Of 88 patients with COVID-19, 59 (67%) were discharged with complete cure and 29 (33%) resulted in death. 46 (52.3%) of the patients were men. PTX-3 median value (IQR) was 3.66 ng/mL (0.9–27.9) in all patients, 3.3 ng/mL (0.9–27.9) in survivors and 3.91 ng/mL (1.9–23.2) in nonsurvivors which was significantly higher (P = 0.045). As a receiver operating characteristic curve analysis the cut-off value of PTX-3 for predicting mortality in patients was 3.73 with 65% sensitivity and 65% specificity (AUC: 0.646, 95% CI: 0.525– 0.767, P = 0.045). Also, we found significant cut-off values with respect to D-dimer, D-dimer/PTX-3, high-sensitivity troponin, highsensitivity troponin/PTX-3, lymphocyte, PTX-3/lymphocyte, procalcitonin, procalcitonin/PTX-3, CRP, and CRP/PTX-3 (P < 0.05). Conclusion: In this study, as far as we know, for the first time, we have shown PTX-3 as the new mortality biomarker for COVID-19 disease.Key words: COVID-19, SARS-CoV-2, pentraxin, disease progression, mortality

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1. Weekly CC, The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) — China, 2020. China CDC Weekly 2020; 2: 113-22. doi: 10.46234/ccdcw2020.032.
2. Messner CB, Demichev V, Wendisch D, Michalick L, White M et al. Ultra-high-throughput clinical proteomics reveals classifiers of COVID-19 ınfection. Cell Systems 2020; 11: 11- 24.e4.
3. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA 2020; 324: 782-93.
4. Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Critical Reviews in Clinical Laboratory Sciences 2020; 57: 389- 399. doi: 10.1080/10408363.2020.1770685.
5. Wang L. C-reactive protein levels in the early stage of COVID-19. Medecine et Maladies Infectieuses 2020; 50: 332- 334.
6. Bottazzi B, Doni A, Garlanda C, Mantovani A. An integrated view of humoral innate immunity: pentraxins as a paradigm. Annual Review of Immunology 2010; 28: 157-183.
7. Introna M, Alles VV, Castellano M, Picardi G, De Gioia L et al. Cloning of mouse ptx3, a new member of the pentraxin gene family expressed at extrahepatic sites. Blood 1996; 87: 1862- 1872.
8. Low GKK, Gan S-C, Zainal N, Naidu KD, Amin-Nordin S et al. The predictive and diagnostic accuracy of vascular endothelial growth factor and pentraxin-3 in severe dengue. Pathogens and Global Health 2018; 112: 334-341.
9. Uusitalo-Seppälä R, Huttunen R, Aittoniemi J, Koskinen P, Leino A et al. Pentraxin 3 (PTX3) is associated with severe sepsis and fatal disease in emergency room patients with suspected infection: a prospective cohort study. PLoS One 2013; 8: e53661.
10. He X, Han B, Liu M. Long pentraxin 3 in pulmonary infection and acute lung injury. American Journal of Physiology-Lung Cellular and Molecular Physiology 2007; 292: L1039-L1049.
11. Tian W, Jiang W, Yao J, Nicholson CJ, Li RH et al. Predictors of mortality in hospitalized COVID-19 patients: a systematic review and meta-analysis. Journal of Medical Virology 2020; 92 (10): 1875-1883. doi: 10.1002/jmv.26050.
12. Rothenburger M, Markewitz A, Lenz T, Kaulbach HG, Marohl K et al. Detection of acute phase response and infection. The role of procalcitonin and C-reactive protein. Clinical Chemistry and Laboratory Medicine 1999; 37: 275-279.
13. Bethell DB, Flobbe K, Cao XT, Day NP, Pham TP et al. Pathophysiologic and prognostic role of cytokines in dengue hemorrhagic fever. The Journal of Infectious Diseases 1998; 177: 778-782.
14. Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Therapeutic Advances in Respiratory Disease 2020; 14. doi: 10.1177/1753466620937175
15. Koozi H, Lengquist M, Frigyesi A. C-reactive protein as a prognostic factor in intensive care admissions for sepsis: a Swedish multicenter study. Journal of Critical Care 2020; 56: 73-79. doi: 10.1016/j.jcrc.2019.12.009
16. Ryoo SM, Han KS, Ahn S, Shin TG, Hwang SY et al. The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients: a multicenter prospective registry-based observational study. Scientific Reports 2019; 9: 6579.
17. Tian F, Li H, Wang L, Li B, Aibibula M et al. The diagnostic value of serum C-reactive protein, procalcitonin, interleukin-6 and lactate dehydrogenase in patients with severe acute pancreatitis. Clinica Chimica Acta 2020; 510: 665-670. doi: 10.1016/j.cca.2020.08.029
18. Song J, Park DW, Moon S, Cho H-J, Park JH et al. Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions. BMC Infectious Diseases 2019; 19: 968.
19. Mantovani A, Garlanda C, Doni A, Bottazzi B. Pentraxins in ınnate ımmunity: from C-reactive protein to the long pentraxin PTX3. Journal of Clinical Immunology 2008; 28: 1-13. doi: 10.1007/s10875-007-9126-7