Process-Specific Blood Biomarkers and Outcomes in COVID-19 Versus Non-COVID-19 ARDS (APEL-COVID Study): A Prospective, Observational Cohort Study

Process-Specific Blood Biomarkers and Outcomes in COVID-19 Versus Non-COVID-19 ARDS (APEL-COVID Study): A Prospective, Observational Cohort Study

Severe acute respiratory syndrome (SARS) and acute respiratory distress syndrome (ARDS) are often considered separate clinico-radiological entities. Whether these conditions also present a single process-specific systemic biomolecular phenotype and how this relates to patient outcomes remains unknow...

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Bibliographic Details
Published in:Journal of clinical medicine Vol. 13; no. 19; p. 5919
Main Authors: Lesur, Olivier, Segal, Eric David, Rego, Kevin, Mercat, Alain, Asfar, Pierre, Chagnon, Frédéric
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 04-10-2024
MDPI
Subjects:
Acute respiratory distress syndrome
Analysis
Biological markers
Biomarkers
Cohort analysis
Coronaviruses
COVID-19
Data collection
Diagnosis
Enzymes
Ethylenediaminetetraacetic acid
Health aspects
Inflammation
Injuries
Intensive care
Lungs
Medical research
Medicine, Experimental
Patient outcomes
Patients
Physiology
Plasma
Proteins
Risk factors
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Ventilators
Canada
United Kingdom
Quebec
COVID-19
ACE2
LOX
NEP
SARS
apelins (APL)
ARDS
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Summary:Severe acute respiratory syndrome (SARS) and acute respiratory distress syndrome (ARDS) are often considered separate clinico-radiological entities. Whether these conditions also present a single process-specific systemic biomolecular phenotype and how this relates to patient outcomes remains unknown. A prospective cohort study was conducted, including adult patients admitted to the ICU and general floors for COVID-19-related (COVID+) or non-COVID-19-related (COVID-) acute respiratory failure during the main phase of the pandemic. The primary objective was to study blood biomarkers and outcomes among different groups and severity subsets. A total of 132 patients were included, as follows: 67 COVID+, 54 COVID- (with 11 matched control subjects for biomarker reference), and 58 of these patients allowed for further pre- and post-analysis. The baseline apelin (APL) levels were higher in COVID+ patients ( < 0.0001 vs. COVID- patients) and in SARS COVID+ patients ( ≤ 0.02 vs. ARDS), while the IL-6 levels were higher in ARDS COVID- patients ( ≤ 0.0001 vs. SARS). Multivariable logistic regression analyses with cohort biomarkers and outcome parameters revealed the following: (i) log-transformed neprilysin (NEP) activity was significantly higher in COVID+ patients (1.11 [95% CI: 0.4-1.9] vs. 0.37 [95% CI: 0.1-0.8], fold change (FC): 1.43 [95% CI: 1.04-1.97], = 0.029) and in SARS patients (FC: 1.65 [95% CI: 1.05-2.6], = 0.032 vs. non-SARS COVID+ patients, and 1.73 [95% CI: 1.19-2.5], = 0.005 vs. ARDS COVID- patients) and (ii) higher lysyl oxidase (LOX) activity and APL levels were respectively associated with death and a shorter length of hospital stay in SARS COVID+ patients (Odds Ratios (OR): 1.01 [1.00-1.02], = 0.05, and OR: -0.007 [-0.013-0.0001], = 0.048). Process-specific blood biomarkers exhibited distinct profiles between COVID+ and COVID- patients, and across stages of severity. NEP and LOX activities, as well as APL levels, are particularly linked to COVID+ patients and their outcomes (ClinicalTrials.gov Identifier: NCT04632732).
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ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13195919