Serum presepsin levels among patients with COVID-19

Background: Presepsin provides information about prognosis of various inflammatory diseases and helps guide therapy. The present study was aimed to evaluate presepsin levels in COVID-19 patients and assess its predictive value on severity and mortality of the disease. Materials and Methods: A total of 259 patients were divided into two groups according to severity of the disease. Patients with mild-moderate illness constituted group 0 and those with severe-critical illness constituted group 1. Biochemical parameters including hemogram, coagulation tests, C-reactive protein (CRP), procalcitonin, creatine kinase, troponin, D-dimer, presepsin, and liver and kidney function tests were assessed for each patient. Results: Group 1 patients were older and had a higher length of hospital stay and mortality compared to group 0 patients. Blood levels of urea, creatinine, lactate dehydrogenase (LDH), aspartate aminotransferase, ferritin, procalcitonin, CRP, activated partial thromboplastin time, troponin, and presepsin were statistically significantly higher and lymphocyte and albumin levels were significantly lower in group 1 patients than that of group 0 patients. Presepsin had a weak positive correlation with LDH (r = 0.147, P = 0.018) and troponin levels (r = 0.141, P = 0.024), and had a weak negative correlation with albumin level (r = -0.134, 0.031). According to multivariate logistic regression analysis, only lymphocyte count was an independent predictor of hospital mortality. Presepsin with a cutoff value of 42.79 pg/ml predicted severe-critical infection with 64.4% sensitivity and 52.5% specificity. It had a lower diagnostic value for prediction of disease severity compared to procalcitonin and CRP. Conclusion: Presepsin might be used in risk stratification of COVID-19 disease. Further studies are needed to delineate its prognostic value for survival.