Frontiers in Cardiovascular Medicine (Oct 2022)

Early carbohydrate antigen 125 as a mortality predictor in hospitalized patients with coronavirus disease 2019

  • Oscar Moreno-Perez,
  • Oscar Moreno-Perez,
  • Julio Nuñez,
  • Julio Nuñez,
  • Julio Nuñez,
  • Miriam Sandin-Rollan,
  • Vicente Arrarte,
  • Vicente Arrarte,
  • Vicente Boix,
  • Vicente Boix,
  • Sergio Reus,
  • Sergio Reus,
  • Hector Pinargote-Celorio,
  • Isabel Ribes,
  • Rocio Alfayate,
  • Maria Belen Llorca-Santos,
  • Maria Angeles Martinez-Garcia,
  • Pablo Chico-Sánchez,
  • Esperanza Merino

DOI
https://doi.org/10.3389/fcvm.2022.941512
Journal volume & issue
Vol. 9

Abstract

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BackgroundCarbohydrate antigen 125 (CA125) is an indicator of inflammation, immune response, and impaired cardiac function. The aim was to investigate whether CA125 behaves as a biomarker of severity and poor clinical outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19).MethodsSerum CA125 [Elecsys CA125 II assay-(Roche Diagnostics GmbH)] was measured in stored biobank samples from COVID-19 hospitalized patients between 01 March 2020 and 17 October 2021. Multiple logistic regression models were built to explore the association between CA125 and clinical outcomes [in-hospital all-cause mortality, need for invasive mechanical ventilation (IMV), or non-invasive respiratory support (non-IRS)], estimating odds ratios (ORs; 95% CI). The gradient of risk of CA125 was evaluated by fractional polynomials.ResultsA total of 691 patients were included, median age of 63 years (50–76), men (57.2%), with high comorbidity. At admission, 85.8% had pneumonia. Median CA125 was 10.33 U/ml (7.48–15.50). The in-hospital mortality rate was 7.2%. After adjusting for confounding factors, CA125 ≥ 15.5 U/ml (75th percentile) showed an increased risk of death [OR 2.85(1.21–6.71)], as age ≥ 65 years, diabetes, and immunosuppression. Furthermore, CA125 as a continuous variable was positive and significantly associated with the risk of death after multivariate adjustment. The mean hospital stay of the patients with CA125 ≥ 15.5 U/ml was longer than the rest of the study population.ConclusionCA125 in the first 72 h of hospital admission seems a useful biomarker of mortality in hospitalized patients with moderate–severe COVID-19. If our findings are confirmed, the wide availability of this biomarker would make easy its widespread implementation in clinical practice.

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