Diagnostic Value of Novel Presepsin and Inflammatory Biomarkers in Predicting the Clinical Course of COVID-19

Aim: The diagnostic value of inflammatory markers to determine the severity of Coronavirus disease-2019 (COVID-19) is postulated in some recent studies, but conclusions were inconsistent. Hence, we intend to examine the utility of presepsin, procalcitonin and C-reactive protein in predicting the severity of COVID-19 infection. Methods: Single-center cross-sectional study was undertaken at the Intensive care unit of a university hospital. Eighty consecutive cases diagnosed with Severe Acute Respiratory syndrome-Coronavirus-2 RNA between October 2020 and July 2021 were classified according to the severity of the disease. Laboratory data related to Procalcitonin and C-reactive protein was retrieved from investigations coinciding with the day of admission. The stored plasma was subjected to an enzyme-linked immunosorbent assay to determine plasma presepsin levels. Statistical test for measures of screening was employed and a receiver operator curve was generated. Results: We have determined that presepsin is the most sensitive prognostic indicator (93.3%) with a strong statistical association (p<0.001) for COVID-19. 15.99 ng/L could be used as a reference level to predict the progressive clinical course. Relatively lower sensitivity (88%) and positive statistical correlation (p=0.049) of C-reactive protein with high-risk infection were also observed. Procalcitonin showed limited diagnostic and prognostic value in our series. Conclusion: Our findings seem to demonstrate the role of presepsin in providing prognostic information in COVID-19 patients. Therefore, we suggest that early monitoring of presepsin with routine marker profile might help in identifying patients suffering from a more severe disease.