Soluble Urokinase Plasminogen Activator Receptor: A Biomarker for Predicting Complications and Critical Care Admission o
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CURRENT OPINION
Soluble Urokinase Plasminogen Activator Receptor: A Biomarker for Predicting Complications and Critical Care Admission of COVID‑19 Patients Athanasios Chalkias1 · Angeliki Mouzarou2 · Evangelia Samara3 · Theodoros Xanthos4 · Eleni Ischaki5 · Ioannis Pantazopoulos6
© Springer Nature Switzerland AG 2020
Abstract The novel coronavirus infection has spread worldwide, causing a wide spectrum of clinical manifestations. Most patients develop moderate clinical illness, but a substantial number will experience severe pneumonia, which may rapidly progress to acute respiratory distress syndrome and multiple organ failure. In this population, soluble urokinase plasminogen activator receptor (suPAR) could serve as a quick triage test and independent marker of clinical severity, hospital and intensive care unit admission, complications, and mortality.
* Athanasios Chalkias [email protected] 1
Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
2
Department of Cardiology, General Hospital of Paphos, Paphos, Cyprus
3
Department of Anesthesiology, Tzaneio General Hospital, Piraeus, Greece
4
School of Medicine, European University Cyprus, Nicosia, Cyprus
5
First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
6
Department of Emergency Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
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A. Chalkias et al.
Key Points Patients with COVID-19 may experience severe pneumonia, acute respiratory distress syndrome, and multiple organ failure. A reliable prognostic biomarker would be invaluable today for the triage of COVID-19 patients. Soluble urokinase plasminogen activator receptor (suPAR) could serve as a quick triage test and independent marker of clinical severity and outcome in this population.
1 Introduction In late 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) was identified as the cause of an outbreak of acute respiratory illness in Wuhan, China. In February 2020, the World Health Organization designated the disease as coronavirus disease 2019 (COVID-19). So far, the infection has spread to include hundreds of thousands worldwide, with confirmed cases increasing despite the austere measures applied [1, 2]. The novel coronavirus causes a wide spectrum of clinical manifestations in humans, with a large fraction of patients developing a short period of moderate clinical illness [1–3]. Nevertheless, a small but substantial number of patients experience severe pneumonia, which may rapidly progress to acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiple organ failure [4]. The disease severity is influenced by many factors, such as the initial viral titers
in the airways, the age, or the comorbid conditions of the infected individual [5]. The pathogenesis of COVID-19 dis
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