PDF(Pubmed)
Abstract：
UNASSIGNED: Previous research has shown that human identical sequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) promote coronavirus disease 2019 (COVID-19) progression by upregulating hyaluronic acid (HA). However, the association of HA with mortality and long COVID in SARS-CoV-2 reinfection and first infection is unclear.
UNASSIGNED: Patients with COVID-19 at Beijing Ditan Hospital from September 2023 to November 2023 were consecutively enrolled. SARS-CoV-2 reinfections were matched 1:2 with first infections using a nearest neighbor propensity score matching algorithm. We compared the hospital outcomes between patients with COVID-19 reinfection and first infection. The association between HA levels and mortality and long COVID in the matched cohort was analyzed.
UNASSIGNED: The reinfection rate among COVID-19 hospitalized patients was 25.4% (62 cases). After propensity score matching, we found that reinfection was associated with a better clinical course and prognosis, including lower levels of C-reactive protein and erythrocyte sedimentation rate, fewer cases of bilateral lung infiltration and respiratory failure, and shorter viral clearance time and duration of symptoms (p < 0.05). HA levels were significantly higher in patients with primary infection [128.0 (90.5, 185.0) vs. 94.5 (62.0, 167.3), p = 0.008], those with prolonged viral clearance time [90.5 (61.5, 130.8) vs. 130.0 (95.0, 188.0), p < 0.001], and deceased patients [105.5 (76.8, 164.5) vs. 188.0 (118.0, 208.0), p = 0.002]. Further analysis showed that HA was an independent predictor of death (AUC: 0.789), and the risk of death increased by 4.435 times (OR = 5.435, 95% CI = 1.205-24.510, p = 0.028) in patients with high HA levels. We found that patients with HA levels above 116 ng/mL had an increased risk of death. However, the incidence of long COVID was similar in the different HA level groups (p > 0.05).
UNASSIGNED: Serum HA may serve as a novel biomarker for predicting COVID-19 mortality in patients with SARS-CoV-2 reinfection and first infection. However, HA levels may not be associated with long COVID.
UNASSIGNED: Patients with COVID-19 at Beijing Ditan Hospital from September 2023 to November 2023 were consecutively enrolled. SARS-CoV-2 reinfections were matched 1:2 with first infections using a nearest neighbor propensity score matching algorithm. We compared the hospital outcomes between patients with COVID-19 reinfection and first infection. The association between HA levels and mortality and long COVID in the matched cohort was analyzed.
UNASSIGNED: The reinfection rate among COVID-19 hospitalized patients was 25.4% (62 cases). After propensity score matching, we found that reinfection was associated with a better clinical course and prognosis, including lower levels of C-reactive protein and erythrocyte sedimentation rate, fewer cases of bilateral lung infiltration and respiratory failure, and shorter viral clearance time and duration of symptoms (p < 0.05). HA levels were significantly higher in patients with primary infection [128.0 (90.5, 185.0) vs. 94.5 (62.0, 167.3), p = 0.008], those with prolonged viral clearance time [90.5 (61.5, 130.8) vs. 130.0 (95.0, 188.0), p < 0.001], and deceased patients [105.5 (76.8, 164.5) vs. 188.0 (118.0, 208.0), p = 0.002]. Further analysis showed that HA was an independent predictor of death (AUC: 0.789), and the risk of death increased by 4.435 times (OR = 5.435, 95% CI = 1.205-24.510, p = 0.028) in patients with high HA levels. We found that patients with HA levels above 116 ng/mL had an increased risk of death. However, the incidence of long COVID was similar in the different HA level groups (p > 0.05).
UNASSIGNED: Serum HA may serve as a novel biomarker for predicting COVID-19 mortality in patients with SARS-CoV-2 reinfection and first infection. However, HA levels may not be associated with long COVID.
摘要：
■先前的研究表明，人类相同的严重急性呼吸道综合症冠状病毒-2（SARS-CoV-2）序列通过上调透明质酸（HA）促进2019年冠状病毒病（COVID-19）的进展。然而,SARS-CoV-2再感染和首次感染中HA与死亡率和长期COVID的关系尚不清楚.
■于2023年9月至2023年11月在北京地坛医院连续入选COVID-19患者。使用最近邻倾向得分匹配算法将SARS-CoV-2再感染与首次感染1：2进行匹配。我们比较了COVID-19再感染和首次感染患者的医院转归。分析了匹配队列中HA水平与死亡率和长COVID之间的关系。
■COVID-19住院患者再感染率为25.4%(62例)。在倾向得分匹配后，我们发现再感染与更好的临床过程和预后相关，包括较低水平的C反应蛋白和红细胞沉降率，减少双侧肺浸润和呼吸衰竭的病例，和较短的病毒清除时间和症状持续时间（p<0.05）。原发性感染患者的HA水平显着升高[128.0（90.5，185.0）与94.5（62.0，167.3），p=0.008],那些病毒清除时间延长[90.5（61.5，130.8）与130.0(95.0,188.0),p<0.001],和死亡患者[105.5（76.8，164.5）与188.0(118.0,208.0),p=0.002]。进一步分析显示，HA是死亡的独立预测因子（AUC：0.789），高HA水平患者的死亡风险增加了4.435倍（OR=5.435，95％CI=1.205-24.510，p=0.028）。我们发现，HA水平高于116ng/mL的患者死亡风险增加。然而,不同HA水平组的长COVID发生率相似(p>0.05)。
■血清HA可能作为预测SARS-CoV-2再感染和首次感染患者COVID-19死亡率的新生物标志物。然而,HA水平可能与长期COVID无关。
■于2023年9月至2023年11月在北京地坛医院连续入选COVID-19患者。使用最近邻倾向得分匹配算法将SARS-CoV-2再感染与首次感染1：2进行匹配。我们比较了COVID-19再感染和首次感染患者的医院转归。分析了匹配队列中HA水平与死亡率和长COVID之间的关系。
■COVID-19住院患者再感染率为25.4%(62例)。在倾向得分匹配后，我们发现再感染与更好的临床过程和预后相关，包括较低水平的C反应蛋白和红细胞沉降率，减少双侧肺浸润和呼吸衰竭的病例，和较短的病毒清除时间和症状持续时间（p<0.05）。原发性感染患者的HA水平显着升高[128.0（90.5，185.0）与94.5（62.0，167.3），p=0.008],那些病毒清除时间延长[90.5（61.5，130.8）与130.0(95.0,188.0),p<0.001],和死亡患者[105.5（76.8，164.5）与188.0(118.0,208.0),p=0.002]。进一步分析显示，HA是死亡的独立预测因子（AUC：0.789），高HA水平患者的死亡风险增加了4.435倍（OR=5.435，95％CI=1.205-24.510，p=0.028）。我们发现，HA水平高于116ng/mL的患者死亡风险增加。然而,不同HA水平组的长COVID发生率相似(p>0.05)。
■血清HA可能作为预测SARS-CoV-2再感染和首次感染患者COVID-19死亡率的新生物标志物。然而,HA水平可能与长期COVID无关。
