Abstract：
BACKGROUND: COVID-19 clinical course is highly variable and secondary infections contribute to COVID-19 complexity. Early detection of secondary infections is clinically relevant for patient outcome. Procalcitonin (PCT) and C-reactive protein (CRP) are the most used biomarkers of infections. Pentraxin 3 (PTX3) is an acute phase protein with promising performance as early biomarker in infections. In patients with COVID-19, PTX3 plasma concentrations at hospital admission are independent predictor of poor outcome. In this study, we assessed whether PTX3 contributes to early identification of co-infections during the course of COVID-19.
METHODS: We analyzed PTX3 levels in patients affected by COVID-19 with (n = 101) or without (n = 179) community or hospital-acquired fungal or bacterial secondary infections (CAIs or HAIs).
RESULTS: PTX3 plasma concentrations at diagnosis of CAI or HAI were significantly higher than those in patients without secondary infections. Compared to PCT and CRP, the increase of PTX3 plasma levels was associated with the highest hazard ratio for CAIs and HAIs (aHR 11.68 and 24.90). In multivariable Cox regression analysis, PTX3 was also the most significant predictor of 28-days mortality or intensive care unit admission of patients with potential co-infections, faring more pronounced than CRP and PCT.
CONCLUSIONS: PTX3 is a promising predictive biomarker for early identification and risk stratification of patients with COVID-19 and co-infections.
BACKGROUND: Dolce & Gabbana fashion house donation; Ministero della Salute for COVID-19; EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT) and MUR PNRR Italian network of excellence for advanced diagnosis (Project no. PNC-E3-2022-23683266 PNC-HLS-DA); EU MSCA (project CORVOS 860044).
METHODS: We analyzed PTX3 levels in patients affected by COVID-19 with (n = 101) or without (n = 179) community or hospital-acquired fungal or bacterial secondary infections (CAIs or HAIs).
RESULTS: PTX3 plasma concentrations at diagnosis of CAI or HAI were significantly higher than those in patients without secondary infections. Compared to PCT and CRP, the increase of PTX3 plasma levels was associated with the highest hazard ratio for CAIs and HAIs (aHR 11.68 and 24.90). In multivariable Cox regression analysis, PTX3 was also the most significant predictor of 28-days mortality or intensive care unit admission of patients with potential co-infections, faring more pronounced than CRP and PCT.
CONCLUSIONS: PTX3 is a promising predictive biomarker for early identification and risk stratification of patients with COVID-19 and co-infections.
BACKGROUND: Dolce & Gabbana fashion house donation; Ministero della Salute for COVID-19; EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT) and MUR PNRR Italian network of excellence for advanced diagnosis (Project no. PNC-E3-2022-23683266 PNC-HLS-DA); EU MSCA (project CORVOS 860044).
摘要：
背景：COVID-19的临床过程变化很大，继发感染导致COVID-19的复杂性。继发感染的早期检测在临床上与患者预后相关。降钙素原（PCT）和C反应蛋白（CRP）是最常用的感染生物标志物。Pentraxin3（PTX3）是一种急性期蛋白，具有作为感染早期生物标志物的良好性能。在COVID-19患者中，入院时的PTX3血浆浓度是预后不良的独立预测因素。在这项研究中,我们评估了PTX3是否有助于COVID-19过程中共同感染的早期识别。
方法：我们分析了患有（n=101）或不患有（n=179）社区或医院获得性真菌或细菌继发感染（CAI或HAI）的COVID-19患者的PTX3水平。
结果：诊断为CAI或HAI时的PTX3血浆浓度明显高于无继发感染的患者。与PCT和CRP相比，PTX3血浆水平的升高与CAI和HAI的最高风险比相关(aHR11.68和24.90).在多变量Cox回归分析中，PTX3也是潜在合并感染患者28天死亡率或重症监护病房住院的最重要预测因素。比CRP和PCT更明显。
结论：PTX3是一种有前景的预测生物标志物，可用于COVID-19和合并感染患者的早期识别和风险分层。
背景：Dolce＆Gabbana时装屋捐赠；为COVID-19致敬部长；欧盟在MURPNRR关于新兴传染病的扩展伙伴关系倡议中提供的资金（项目编号：PE00000007，INF-ACT）和MURPNRR意大利卓越网络，用于高级诊断（项目编号PNC-E3-2022-23683266PNC-HLS-DA）；欧盟MSCA（项目CORVOS860044）。
方法：我们分析了患有（n=101）或不患有（n=179）社区或医院获得性真菌或细菌继发感染（CAI或HAI）的COVID-19患者的PTX3水平。
结果：诊断为CAI或HAI时的PTX3血浆浓度明显高于无继发感染的患者。与PCT和CRP相比，PTX3血浆水平的升高与CAI和HAI的最高风险比相关(aHR11.68和24.90).在多变量Cox回归分析中，PTX3也是潜在合并感染患者28天死亡率或重症监护病房住院的最重要预测因素。比CRP和PCT更明显。
结论：PTX3是一种有前景的预测生物标志物，可用于COVID-19和合并感染患者的早期识别和风险分层。
背景：Dolce＆Gabbana时装屋捐赠；为COVID-19致敬部长；欧盟在MURPNRR关于新兴传染病的扩展伙伴关系倡议中提供的资金（项目编号：PE00000007，INF-ACT）和MURPNRR意大利卓越网络，用于高级诊断（项目编号PNC-E3-2022-23683266PNC-HLS-DA）；欧盟MSCA（项目CORVOS860044）。
