Predictive value of HE4 in conjunction with inflammatory markers for severity stratification of COVID-19 patients
Objective To investigate the level of human epididymal protein 4(HE4)and its predictive value for the progression to severe in COVID-19 patients.Methods A total of 144 COVID-19 patients were selected as the infection group,while 50 healthy individuals served as the control group.Serum levels of HE4 and other inflammatory markers,including CRP,IL-6,PCT,and Ferritin,were measured upon admission.COVID-19 patients were classified into mild(including asymptomatic and moderate)and se vere groups(including severe and critical cases),comparing the differences in serum levels of HE4 and other inflammatory markers.Mul-tivariable logistic regression analysis was employed to explore risk factors associated with severe progression,and receiver operat ing characteristic(ROC)curves were constructed to evaluate the predictive value of each marker for severe COVID-19.Results Up-on admission,serum levels of HE4,CRP,IL-6,PCT,Ferritin,NLR,C3,and C4 in COVID-19 patients were significantly elevated com-pared to the control group(P＜0.01).Among those who progressed to severe disease,initial serum levels of HE4,CRP,IL-6,PCT,Fer-ritin,and NLR were significantly higher than those in the mild group(P＜0.05).The multivariable logistic regression model identified HE4,CRP,and NLR as independent risk factors for severe COVID-19.ROC curve analysis revealed that the area under the curve for the individual predictions of severe progression were 0.856,0.815,and 0.781,with critical values of 7.89 mg/dL,151 pmol/L,and 6.355,respectively,corresponding to the maximum Youden index.The sensitivity and specificity of HE4 were found to be 91.11％and 67.37％,respectively.The combined assessment of HE4,CRP,and NLR yielded an area under the curve of 0.890,with a sen-sitivity of 84.09％and specificity of 79.76％.Conclusion HE4 demonstrated the highest predictive efficacy for severe COVID-19 upon admission and has the potential to serve as a biomarker for predicting severe progression in CO VID-19 patients.The joint as-sessment of HE4 with CRP and NLR provides enhanced accuracy and clinical significance in predicting severe COVID-19 out-comes.
Human epididymal protein 4COVID-19Inflammatory markersDisease severity
万方数据
维普
