Association of serum copeptin levels with pulmonary complications and heart right ventricular functions in common variable immunodeficiency.

Background and aims: Common variable immunodeficiency (CVID) represents the most frequently diagnosed symptomatic primary immunodeficiency (PID), marked by a heterogeneous presentation involving infectious and non-infectious symptoms. This study investigated the association between serum copeptin levels and right ventricular functions (RVF) and pulmonary complications in patients diagnosed with CVID.

Methods: The study analyzed data from 60 individuals with a confirmed diagnosis of CVID and 30 age- and sex-matched healthy volunteers (HVs). Clinical and biochemical parameters were sourced from existing hospital records.CVID patients were categorized into two subgroups: those with and without pulmonary complications. Comparisons of serum copeptin levels were made between these groups and between the overall CVID cohort and healthy controls. RVF was evaluated using tricuspid annular plane systolic excursion (TAPSE) and supplementary echocardiographic indicators.

Results: The CVID group had a median age of 40 years (interquartile range [IQR]: 30-55), with 51.7% being male, while the HVs group had a median age of 37 years (IQR: 28-47.5), with 60% male. No significant differences in age (p = 0.226) or sex distribution (p = 0.45) were observed between the groups. CVID with pulmonary complications (CVID-P) exhibited significantly elevated copeptin levels compared to those without such complications (p < 0.001). According to ROC analysis, a copeptin cut-off value of 11 pmol/L significantly differentiated patients with CVID-P from those without pulmonary complications (p < 0.001). Moreover, overall copeptin levels were significantly higher in the CVID group than in HVs (p < 0.001). A copeptin cut-off value of 21 pmol/L effectively distinguished CVID patients with low TAPSE from those with normal TAPSE values (p < 0.001). Pulmonary complications and low TAPSE were independently associated with increased copeptin levels (p = 0.006 and p = 0.004, respectively).

Conclusion: The development of pulmonary complications and RV dysfunction were associated with elevated serum copeptin levels in CVID. Measuring serum copeptin concentration may be a useful biomarker in diagnosing and prognosis pulmonary diseases and RV dysfunction in CVID.