The Role of Presepsin in Predicting Severe Coronavirus Disease-2019 Pneumonia Prognosis

Introduction: There are several biomarkers to predict disease severity in Coronavirus disease-2019 (COVID-19); however, more precise biomarkers are still needed to evaluate the disease course. This study aimed to evaluate a potential biomarker, a soluble cluster of differentiation 14 subtype (sCD14-ST, Presepsin), to predict the disease prognosis in severe COVID-19 pneumonia. Methods: This study included 60 randomly selected patients, whose diagnosis was confirmed with severe acute respiratory syndrome-coronavirus-2 nucleic acid reverse transcription-polymerase chain reaction and who were hospitalized with severe COVID-19 pneumonia, and 25 healthy controls. All patients' clinical and laboratory data were recorded. On day 1 after admission, venous blood samples were tested for C-reactive protein (CRP), procalcitonin, fibrinogen, hemogram, presepsin, and other laboratory tests (creatinine, aspartate aminotransferase, alanine transaminase, creatine kinase, lactate dehydrogenase, and electrolytes). Mortality rate, intubation rate, and duration of continuous O-2 treatment were recorded. Results were evaluated with Statistical Package for the Social Sciences. Results: This study included 60 patients with COVID-19 infection as the patient group and 25 participants in the control group, with a total of 85 participants. The mean presepsin levels were significantly higher in the patient group compared to the control group (1.483 +/- 0.147 ng/mL vs 0.873 +/- 0.103 ng/mL). Presepsin levels had a weak positive correlation with CRP levels and a strong correlation with procalcitonin levels and creatinine levels. In the patient group, 53 participants have recovered and were discharged, whereas 7 died. No significant difference was found for the presepsin levels in recovering and dying patients in the patient group. Conclusion: New biomarkers are needed to predict prognosis and mortality in severe COVID-19. Presepsin might be promising to predict disease severity in patients with severe COVID-19, especially in special groups, such as patients with chronic renal failure.