Background and aims Neutrophil-derived heparin binding protein (HBP; also known as azurocidin or CAP-37) is a key player in bacterial sepsis and a promising biomarker in severe infections. The aims of this study were to assess whether HBP is involved in the pathophysiology of COVID-19 and, if so, whether it can be used to predict severe disease preferably using a point-of-care test. Methods This was a prospective convenience sample study of biomarkers in patients admitted to Skåne University hospital in Sweden with a confirmed COVID-19 diagnosis. Plasma samples and clinical data were collected within 72h after admission, during hospital stay and at discharge. Plasma HBP concentrations samples were measured both with enzyme-linked immunosorbent assay (ELISA) and with a novel dry immunofluorescence analyzer (Joinstar) point-of-care test. Results Thirty-five COVID-19 patients were enrolled in the study. Twenty-nine patients had blood samples taken within 72h after admission. We compared the highest HBP value taken within 72h after admission in patients who eventually developed organ dysfunction (n = 23) compared to those who did not (n = 6), and found that HBP was significantly elevated in those who developed organ dysfunction (25.0 ng/mL (interquartile range (IQR) 16.6–48.5) vs 10.6 ng/mL (IQR 4.8–21.7 ng/mL), p = 0.03). Point-of-care test measurements correlated well with ELISA measurements (R = 0.83). HBP measured by the POC device predicted development of COVID-induced organ dysfunction with an AUC of 0.88 (95% confidence interval (CI) 0.70–1.0). Conclusions HBP is elevated prior to onset of organ dysfunction in patients with severe COVID-19 using a newly developed point-of-care test and hence HBP could be used in a clinical setting as a prognostic marker in COVID-19.
【초록키워드】 COVID-19, Biomarker, Biomarkers, severe COVID-19, hospital, POC, neutrophil, Sepsis, heparin, discharge, ELISA, Protein, point-of-care, enzyme-linked immunosorbent assay, pathophysiology, Patient, COVID-19 diagnosis, organ dysfunction, Prognostic marker, immunofluorescence, university, Admission, predict, Bacterial sepsis, binding, Concentration, severe disease, COVID-19 patient, AUC, Hospital stay, interquartile range, 95% confidence interval, Blood samples, Clinical data, enzyme, plasma samples, blood sample, severe infections, clinical setting, aims, enzyme-linked immunosorbent, Result, enrolled, highest, predicted, collected, significantly, involved, elevated, can be used, correlated, were measured, IQR, 【제목키워드】 Protein, binding, prospective observational cohort,