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Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19

Mathias Van Singer1, Thomas Brahier2, Jana Koch3

  • 1Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland. mathias.van-singer@chuv.ch.

BMC Infectious Diseases
|September 26, 2023
PubMed

Insights

The soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) algorithm accurately predicts severe COVID-19 outcomes, showing good reproducibility. Interleukin-6 (IL-6) algorithm performance was acceptable but requires further validation.

Area of Science:

  • Biochemistry
  • Immunology
  • Critical Care Medicine

Background:

  • Previous research indicated that soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and Interleukin-6 (IL-6) algorithms effectively predicted adverse outcomes in COVID-19 patients in an Emergency Department (ED) setting.
  • The existing algorithms require validation in diverse clinical settings to confirm their predictive utility.

Purpose of the Study:

  • To validate the performance of sTREM-1 and IL-6-based algorithms for predicting adverse outcomes in COVID-19 patients presenting to the ED.
  • To assess the predictive accuracy of the sTREM-1 algorithm for 30-day intubation or mortality.
  • To evaluate the performance of the IL-6 algorithm for predicting 30-day oxygen requirement.

Main Methods:

  • A multicentric prospective observational study involving PCR-confirmed adult COVID-19 patients across three Swiss hospital EDs.
  • Retrospective data compilation and merging from the participating centers.
  • Determination of the predictive accuracy of the sTREM-1 algorithm for 30-day intubation/mortality and the IL-6 algorithm for 30-day oxygen requirement.

Main Results:

  • The validation cohort included 373 patients, with 18% experiencing death or intubation by day 30.
  • The sTREM-1 algorithm demonstrated high sensitivity (90%) and negative predictive value (94%) for 30-day intubation/mortality, consistent with the derivation cohort.
  • The IL-6 algorithm showed acceptable sensitivity (85%) and negative predictive value (60%) for 30-day oxygen requirement, though lower than the derivation cohort.

Conclusions:

  • The sTREM-1 algorithm exhibited good reproducibility across multiple centers, supporting its clinical utility.
  • Further prospective randomized controlled trials are needed to evaluate the safety and impact of the sTREM-1 algorithm on hospital and ICU admission rates.
  • The IL-6 algorithm's validity requires additional multi-center validation before widespread implementation.
Abstract

Keywords:
BiomarkersCOVID-19Clinical support decision toolValidation studysTREM-1

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