HEPARIN-BINDING PROTEIN LEVELS PREDICT UNFAVORABLE OUTCOME IN COVID-19 PNEUMONIA: A POST HOC ANALYSIS OF THE SAVE TRIAL

We aimed to evaluate heparin-binding protein (HBP) as a marker of prognosis of unfavorable outcome in COVID-19 pneumonia. This was a post hoc analysis of the SAVE clinical trial investigating anakinra treatment, guided by suPAR (soluble urokinase plasminogen activator receptor) levels ≥6 ng/mL, for...

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Published in:	Shock (Augusta, Ga.) Vol. 61; no. 3; pp. 395 - 399
Main Authors:	Kyriazopoulou, Evdoxia, Dalekos, George N, Metallidis, Symeon, Poulakou, Garyphalia, Papanikolaou, Ilias C, Tzavara, Vasiliki, Argyraki, Katerina, Alexiou, Zoi, Panagopoulos, Periklis, Samarkos, Michael, Chrysos, George, Tseliou, Aikaterini, Milionis, Haralampos, Sympardi, Styliani, Vasishta, Anil, Giamarellos-Bourboulis, Evangelos J
Format:	Journal Article
Language:	English
Published:	United States 01-03-2024
Subjects:	Antimicrobial Cationic Peptides Biomarkers Blood Proteins COVID-19 Humans Interleukin 1 Receptor Antagonist Protein - therapeutic use Prognosis Respiratory Insufficiency
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Summary:	We aimed to evaluate heparin-binding protein (HBP) as a marker of prognosis of unfavorable outcome in COVID-19 pneumonia. This was a post hoc analysis of the SAVE clinical trial investigating anakinra treatment, guided by suPAR (soluble urokinase plasminogen activator receptor) levels ≥6 ng/mL, for the prevention of severe respiratory failure in hospitalized patients with COVID-19 pneumonia. Baseline HBP plasma levels were measured in 534 patients by fluorescence dry quantitative immunoassay using the Jet-iStar 800 analyzer. Concentrations higher than 35 ng/mL predicted 30-day mortality with a moderate specificity of 53.3% and negative predictive value 78.1%; sensitivity was low (29.0%). After multivariate Cox analysis, HBP higher than 35 ng/mL was an independent predictor of 30-day unfavorable outcome (adjusted hazard ratio, 1.77; 95% CI, 1.06-2.94; P = 0.028) and these patients were also at greater risk of death after 90 days (hazard ratio, 1.85; 95% CI, 1.25-2.74; P = 0.002). The cutoff was not predictive of development of severe respiratory failure, septic shock or acute kidney injury. Among patients with baseline HBP levels higher than 35 ng/mL, anakinra treatment was associated with decreased mortality (7.2%) versus comparators (18.1%; P < 0.001). Results confirm that HBP may be an early biomarker of poor outcome among preselected patients at risk from COVID-19 pneumonia.ClinicalTrials.gov registration NCT04357366.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1073-2322 1540-0514
DOI:	10.1097/SHK.0000000000002315