Abstract
Infectious and inflammatory stimuli elicit the generation of chitinase-3-like protein-1 (CHI3L1), involved in tissue damage, repair and remodeling. We evaluated whether plasma CHI3L1 at disease onset predicts clinical outcome of patients with Coronavirus 2019 (COVID-19) disease. Blood from 191 prospectively followed COVID-19 patients were collected at hospital admission between March 18th and May 5th, 2020. Plasma from 80 survivors was collected one month post-discharge. Forty age- and sex-matched healthy volunteers served as controls. Primary outcome was transfer to intensive care unit (ICU) or death. CHI3L1 was higher in COVID-19 patients than controls (p < 0.0001). Patients with unfavorable outcome (41 patients admitted to ICU, 47 died) had significantly higher CHI3L1 levels than non-ICU survivors (p < 0.0001). CHI3L1 levels abated in survivors one month post-discharge, regardless of initial disease severity (p < 0.0001), although remaining higher than controls (p < 0.05). Cox regression analysis revealed that CHI3L1 levels predict primary outcome independently of age, sex, comorbidities, degree of respiratory insufficiency and systemic inflammation or time from symptom onset to sampling (p < 0.0001). Kaplan–Meier curve analysis confirmed that patients with CHI3L1 levels above the median (361 ng/mL) had a poorer prognosis (log rank test, p < 0.0001). Plasma CHI3L1 is increased in COVID-19 patients and predicts adverse outcome.
【초록키워드】 COVID-19, intensive care, Prognosis, disease severity, Comorbidities, Sex, outcome, ICU, Clinical outcome, adverse outcome, Patient, Control, death, plasma, age, Hospital admission, systemic inflammation, disease, predict, Analysis, CHI3L1, COVID-19 patient, disease onset, symptom onset, Primary outcome, tissue damage, Cox regression analysis, non-ICU, transfer, survivor, inflammatory stimuli, Kaplan–Meier, controls, initial, log rank test, collected, died, involved, evaluated, was collected, elicit, significantly higher, admitted to ICU, healthy volunteer, the median, 【제목키워드】 COVID-19, prospective cohort study, Hospital admission, predict,