Presepsin as a Novel Biomarker in predicting Inhospital Mortality in COVID-19 Pneumonia Patients


Objectives: Different biomarkers such as CRP, serum ferritin and D dimer are used in prognostic assessment of patients with COVID-19 pneumonia. Presepsin(PSP) is a soluble CD14 subtype has recently been proposed as a novel biomarker in sepsis patients. The aim of the current study was to detect the relation of presepsin to the outcome of COVID-19 as well as its relation to other inflammatory biomarkers.

Methods: Multicenter, retrospective observational study was conducted in Saudi Arabia and Misr International Hospital, Egypt from January 2021 to May 2021. Hospitalized patients who had positive throat swab of SARS-COV2 and radiological evidence of viral pneumonia (moderate and severe forms) were included in the study. Demographics and clinical features, as well as laboratory parameters including serum ferritin, CRP, D-dimer, presepsin of enrolled patients were retrospectively collected. Pneumonia severity index (PSI) was used to evaluate the severity of pneumonia.

Results: 202 hospitalized patients were diagnosed with COVID-19 pneumonia and had positive results of SARS-CoV-2 RNA; were enrolled to our study. Out of 202 hospitalized patients 67 patients (33.17%) required ICU admission. One hundred seventy-six (87.1%) patients survived and were discharged, 26 (12.9%) patients didn’t survive. Presepsin level was found to be significantly elevated in non-survivor versus survivor group, median (IQR),978.5(755.8-1400) vs 516.5(343.3-720), p<0.001 as well in ICU versus non-ICU patients, median (IQR), 800(631-1200) and 446(320-626), respectively (P value<0.001). Elevated levels were also found to be associated with increase length of hospital stay. Levels above 775 pg/ml were found to be associated with in-hospital mortality specificity 80%, sensitivity 73%.

Conclusion: Elevated presepsin levels indicated poor outcomes in hospitalized COVID-19 pneumonia and was associated with in-hospital mortality.

Keywords: Presepsin, Covid-19, inflammatory markers, soluble CD-14, CRP, Ferritin, D-dimer, sepsis.