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EASIX for Prediction of Outcome in Hospitalized SARS-CoV-2 Infected Patients.
Luft, Thomas; Wendtner, Clemens-Martin; Kosely, Florentina; Radujkovic, Aleksandar; Benner, Axel; Korell, Felix; Kihm, Lars; Bauer, Matthias F; Dreger, Peter; Merle, Uta.
  • Luft T; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
  • Wendtner CM; Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilians University (LMU), Munich, Germany.
  • Kosely F; Medical Department B, Hospital Ludwigshafen, Ludwigshafen, Germany.
  • Radujkovic A; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
  • Benner A; Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany.
  • Korell F; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
  • Kihm L; Department of Internal Medicine I, University of Heidelberg, Heidelberg, Germany.
  • Bauer MF; Institute of Laboratory Diagnostics, Hygiene and Transfusion Medicine, Hospital Ludwigshafen, Ludwigshafen, Germany.
  • Dreger P; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
  • Merle U; Department of Internal Medicine IV, University of Heidelberg, Heidelberg, Germany.
Front Immunol ; 12: 634416, 2021.
Article in English | MEDLINE | ID: covidwho-1305641
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has evoked a pandemic that challenges public health-care systems worldwide. Endothelial cell dysfunction plays a key role in pathophysiology, and simple prognosticators may help to optimize allocation of limited resources. Endothelial activation and stress index (EASIX) is a validated predictor of endothelial complications and outcome after allogeneic stem cell transplantation. Aim of this study was to test if EASIX could predict life-threatening complications in patients with COVID-19.

METHODS:

SARS-CoV-2-positive, hospitalized patients were enrolled onto a prospective non-interventional register study (n=100). Biomarkers were assessed at hospital admission. Primary endpoint was severe course of disease (mechanical ventilation and/or death, V/D). Results were validated in 126 patients treated in two independent institutions.

RESULTS:

EASIX at admission was a strong predictor of severe course of the disease (odds ratio for a two-fold change 3.4, 95%CI 1.8-6.3, p<0.001), time to V/D (hazard ratio (HR) for a two-fold change 2.0, 95%CI 1.5-2.6, p<0.001) as well as survival (HR for a two-fold change 1.7, 95%CI 1.2-2.5, p=0.006). The effect was retained in multivariable analysis adjusting for age, gender, and comorbidities and could be validated in the independent cohort. At hospital admission EASIX correlated with increased suppressor of tumorigenicity-2, soluble thrombomodulin, angiopoietin-2, CXCL8, CXCL9 and interleukin-18, but not interferon-alpha.

CONCLUSION:

EASIX is a validated predictor of COVID19 outcome and an easy-to-access tool to segregate patients in need for intensive surveillance.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Hematopoietic Stem Cell Transplantation / Endothelial Cells / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.634416

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Hematopoietic Stem Cell Transplantation / Endothelial Cells / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.634416