key: cord-317451-gv9q7sf1
authors: Fukada, Ai; Kitagawa, Yutaro; Matsuoka, Masaru; Sakai, Jun; Imai, Kazuo; Norihito, Tarumoto; Orihara, Yuta; Kawamura, Rieko; Takeuchi, Shinichi; Maesaki, Shigefumi; Maeda, Takuya
title: Presepsin as a predictive biomarker of severity in COVID‐19: a case series
date: 2020-06-12
journal: J Med Virol
DOI: 10.1002/jmv.26164
sha: 
doc_id: 317451
cord_uid: gv9q7sf1

Guidelines for the diagnosis and treatment of the novel coronavirus disease 2019 (COVID‐19) present clear criteria, including respiratory rate, hemoglobin oxygen saturation (SaO(2)), and oxygenation indicator (PaO(2)/FiO(2))(1). This article is protected by copyright. All rights reserved.

University Hospital from February to March 2020. Disease severity was classified according to the Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment (7th Edition) 6 . The 6 patients were at different stages and had different severity of infection. Three had moderate disease on admission that was later determined to be severe COVID-19 (the moderate-to-severe group), in whom secondary worsening resulted in invasive mechanical ventilation (Cases 1-3); 1 of these intubated patients ultimately died of COVID-19 pneumonia (Case 1). The other 3 patients (Cases 4-6) were diagnosed as having mild COVID-19 (mild group). The Supplementary Table 1 shows the baseline clinical laboratory findings.

The initial clinical laboratory workup included a complete blood count and the inflammatory biomarker profiles for C-reactive protein (CRP), P-SEP, procalcitonin (PCT), and Krebs von den Lungen-6 (KL-6). The Figure 1 shows clinical course of each patient in terms of changes in laboratory findings and in treatment outcome until discharge alive, transfer from infectious disease ward, or death. P-SEP levels were measured using the STACIA  clinical assay system (LSI Medience Corporation, Tokyo, Japan) based on a chemiluminescent enzyme immunoassay, which has a normal reference range of 59-250 pg/mL.

The majority of serum biochemical markers, including white blood cell, lymphocyte, and platelet counts, showed no differences between the mild and severe COVID-19 groups. P-SEP and CRP were higher on admission in the moderate-to-severe group than in those in the mild group, although PCT was slightly higher in the moderate-to-severe group. Baseline KL-6 levels for both groups were within normal limits (Supplementary Table 1 ). The Figure 1 shows the This article is protected by copyright. All rights reserved.

The notice of launching guideline on diagnosis and treatment of the novel coronavirus pneumonia (NCP)