sTREM-1 as a Predictive Biomarker for Disease Severity and Prognosis in COVID-19 Patients

Abstract

Nan Geng,1,* Zhipeng Wu,2– 4,* Zhao Liu,1 Wen Pan,1 Yueke Zhu,1 Hongbo Shi,3 Ying Han,5 Yingmin Ma,2– 4 Bo Liu1 1Department of Emergency Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 3Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 4Beijing Research Center for Respiratory Infectious Diseases, Beijing, 100013, People’s Republic of China; 5Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yingmin Ma, Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmenwai Street, Fengtai District, Beijing City, 100069, People’s Republic of China, Email [email protected] Bo Liu, Department of Emergency Medicine, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmenwai Street, Fengtai District, Beijing City, 100069, People’s Republic of China, Email [email protected]: Research on biomarkers associated with the severity and adverse prognosis of COVID-19 can be beneficial for improving patient outcomes. However, there is limited research on the role of soluble TREM-1 (sTREM-1) in predicting the severity and prognosis of COVID-19 patients.Methods: A total of 115 COVID-19 patients admitted to the emergency department of Beijing Youan Hospital from February to May 2023 were included in the study. Demographic information, laboratory measurements, and blood samples for sTREM-1 levels were collected upon admission.Results: Our study found that sTREM-1 levels in the plasma of COVID-19 patients increased with the severity of the disease (moderate vs mild, p=0.0013; severe vs moderate, p=0.0195). sTREM-1 had good predictive value for disease severity and 28-day mortality (area under the ROC curve was 0.762 and 0.805, respectively). sTREM-1 also exhibited significant correlations with age, body temperature, respiratory rate, PaO2/FiO2, PCT, CRP, and CAR. Ultimately, through multivariate logistic regression analysis, we determined that sTREM-1 (OR 1.008, 95% CI: 1.002– 1.013, p=0.005), HGB (OR 0.966, 95% CI: 0.935– 0.998, p=0.036), D-dimer (OR 1.001, 95% CI: 1.000– 1.001, p=0.009), and CAR (OR 1.761, 95% CI: 1.154– 2.688, p=0.009) were independent predictors of 28-day mortality in COVID-19 patients. The combination of these four markers yielded a strong predictive value for 28-day mortality in COVID-19 cases with an AUC of 0.919 (95% CI: 0.857 − 0.981).Conclusion: sTREM-1 demonstrated good predictive value for disease severity and 28-day mortality, serving as an independent prognostic factor for adverse patient outcomes. In the future, we anticipate conducting large-scale multicenter studies to validate our research findings.Keywords: COVID-19, sTREM-1, inflammation-related markers, disease severity, 28-day mortality

Keywords

• covid-19
• strem-1
• inflammation-related markers
• disease severity
• 28-day mortality