29-mRNA host response signatures for classification of bacterial infection, viral infection and disease progression in COVID-19 pneumonia: a post hoc analysis of the SAVE-MORE randomized clinical trial.

IF 2.8 Q2 CRITICAL CARE MEDICINE
Evdoxia Kyriazopoulou, Antigone Kotsaki, Asimina Safarika, Garyfallia Poulakou, Haralampos Milionis, Simeon Metallidis, Georgios Adamis, Archontoula Fragkou, Aggeliki Rapti, Pierluigi Del Vecchio, Ioannis Kalomenidis, Danae Kitzoglou, Andrea Angheben, Ilias Kainis, Konstantina Iliopoulou, Francesco Saverio Serino, Petros Bakakos, Vassiliki Tzavara, Sofia Ioannou, Lorenzo Dagna, Katerina Dimakou, Glykeria Tzatzagou, Maria Chini, Matteo Bassetti, Vasileios Kotsis, George Tsoukalas, Carlo Selmi, Sofia Nikolakopoulou, Michael Samarkos, Michael Doumas, Aikaterini Masgala, Ilias Papanikolaou, Aikaterini Argyraki, Karolina Akinosoglou, Styliani Symbardi, Periklis Panagopoulos, George N Dalekos, Oliver Liesenfeld, Timothy E Sweeney, Purvesh Khatri, Evangelos J Giamarellos-Bourboulis
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引用次数: 0

Abstract

Background: Biomarkers based on host response signatures are currently under development for the critically ill. We applied a 29-mRNA classifier for the diagnosis and prognosis of suspected acute infection and sepsis (TriVerity, Inflammatix Inc.) in patients hospitalized with COVID-19.

Methods: We applied three scores from locked classifiers (IMX-BVN-4 and IMX-SEV-4) from the 29-mRNA TriVerity blood test in participants of the SAVE-MORE randomized clinical trial (ClinicalTrials.gov NCT04680949) at baseline and days 4 and 7 of treatment, to classify bacterial infection, viral infection and decompensation. Participants were adults hospitalized with confirmed COVID-19 pneumonia and plasma soluble urokinase plasminogen activator receptor (suPAR) levels of ≥ 6 ng/ml, randomized to placebo or anakinra treatment.

Results: A total of 471 patients were studied. At baseline nearly 90% had a Very Low or Low IMX-BVN-4 Bacterial Score and Moderate, High or Very High IMX-BVN-4 Viral Score. Anakinra treatment had an effect on the expression of genes indicating IMX-SEV-4 High or Very High scores after a 7 day treatment compared to baseline (12.9% of anakinra-treated patients continued being classified as high severity vs 20.4% of placebo-treated patients, p 0.046).

Conclusions: The classifiers were well tested in COVID-19 pneumonia and may become a useful tool for hospitalized patients.

29-mRNA宿主反应特征对COVID-19肺炎细菌感染、病毒感染和疾病进展的分类:SAVE-MORE随机临床试验的事后分析
背景:基于宿主反应特征的生物标志物目前正在开发中,用于危重患者。我们应用一种29-mRNA分类器对住院的COVID-19患者进行疑似急性感染和败血症的诊断和预后(TriVerity™,inflammatory Inc.)。方法:我们在基线和治疗的第4天和第7天对SAVE-MORE随机临床试验(ClinicalTrials.gov NCT04680949)参与者的29-mRNA TriVerity™血液检测中使用锁定分类器(IMX-BVN-4和IMX-SEV-4)的三个评分,对细菌感染、病毒感染和代偿失代偿进行分类。参与者是确诊为COVID-19肺炎且血浆可溶性尿激酶纤溶酶原激活剂受体(suPAR)水平≥6 ng/ml的住院成年人,随机分为安慰剂组或阿那白那组。结果:共纳入471例患者。在基线时,近90%的患者IMX-BVN-4细菌评分很低或很低,IMX-BVN-4病毒评分中等、高或很高。与基线相比,Anakinra治疗对7天治疗后IMX-SEV-4高或非常高评分的基因表达有影响(12.9%的Anakinra治疗患者继续被归类为高严重程度,而安慰剂治疗患者为20.4%,p 0.046)。结论:该分类器在COVID-19肺炎中得到了很好的检验,可能成为住院患者的有用工具。
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来源期刊
Intensive Care Medicine Experimental
Intensive Care Medicine Experimental CRITICAL CARE MEDICINE-
CiteScore
5.10
自引率
2.90%
发文量
48
审稿时长
13 weeks
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