Plasma neutrophil gelatinase-associated lipocalin independently predicts dialysis need and mortality in critical COVID-19.

Neutrophil gelatinase-associated lipocalin (NGAL) is a novel kidney injury and inflammation biomarker. We investigated whether NGAL could be used to predict continuous renal replacement therapy (CRRT) and mortality in critical coronavirus disease 2019 (COVID-19). This prospective multicenter cohort study included adult COVID-19 patients in six intensive care units (ICUs) in Sweden between May 11, 2020 and May 10, 2021. Blood was sampled at admission, days two and seven in the ICU. The samples were batch analyzed for NGAL, creatinine, and cystatin c after the end of the study period. Initiation of CRRT and 90-day survival were used as dependent variables in regression models. Of 498 included patients, 494 were analyzed regarding CRRT and 399 were analyzed regarding survival. Seventy patients received CRRT and 154 patients did not survive past 90 days. NGAL, in combination with creatinine and cystatin c, predicted the subsequent initiation of CRRT with an area under the curve (AUC) of 0.95. For mortality, NGAL, in combination with age and sex, had an AUC of 0.83. In conclusion, NGAL is a valuable biomarker for predicting subsequent initiation of CRRT and 90-day mortality in critical COVID-19. NGAL should be considered when developing future clinical scoring systems.

Hydrophilic polymer supports for solid-phase synthesis: hydroxyl-functional beads of poly(vinylpyrrolidone).

Poly(vinylpyrrolidone) (PVP) has solubility properties that make it an attractive material for polymer-assisted synthesis applications; however, the naked polymer lacks reactive groups upon which to do chemistry. Furthermore, large differences in radical reactivity between 1-vinylpyrrolidin-2-one (NVP) and most other monomers lead to compositional drift during copolymerization, further complicating the introduction of functional groups into the polymer using this method. Monomers that are derivatives of NVP itself are expected to show smaller differences in radical reactivity and therefore provide a way of preparing PVP with adjustable properties. Three monomers introducing hydroxyl-functional groups and a new cross-linker, all derivatives of NVP, were synthesized and used in the preparation of a new type of hydrophilic polymer beads by aqueous suspension polymerization. These lightly cross-linked beads contain hydroxyl groups at a functional loading of 0.21-0.29 mmol/g and swell extensively in a broad range of solvents.