Related Experiment Video
Updated: Jul 9, 2025
Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
Published on: August 4, 2023
Variation in presepsin and thrombomodulin levels for predicting COVID-19 mortality
Azusa Yamazaki1,2, Yoko Nukui3,4, Takahiro Kameda1
1Department of Clinical Bioanalysis and Molecular Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Insights
Thrombomodulin (TM) and presepsin (P-SEP) show promise as biomarkers for predicting COVID-19 patient mortality. Elevated levels and changes in P-SEP can indicate prognosis, independent of kidney function.
Area of Science:
- Biomarkers and Diagnostics
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease (COVID-19) has resulted in significant global mortality.
- Identifying reliable biomarkers for predicting COVID-19 severity and prognosis is crucial for patient management.
- Presepsin (P-SEP) and thrombomodulin (TM) are recognized biomarkers for sepsis and endothelial dysfunction, respectively.
Purpose of the Study:
- To evaluate the utility of presepsin (P-SEP) and thrombomodulin (TM) as prognostic markers in COVID-19 patients.
- To assess the correlation between P-SEP and TM levels with disease severity and patient survival.
- To determine if P-SEP and TM can serve as independent predictors of mortality, even when considering renal function.
Main Methods:
- Serum levels of P-SEP and TM were measured in 183 COVID-19 patients.
- Patients were categorized by disease severity (mild to severe) based on clinical parameters like oxygen saturation and ICU admission criteria.
- P-SEP and TM levels were analyzed in relation to disease severity, survival outcomes (survivors vs. non-survivors), and adjusted for creatinine levels.
Main Results:
- P-SEP and TM levels were significantly elevated in severe COVID-19 cases compared to mild cases, even after creatinine adjustment.
- TM levels were significantly higher in non-survivors compared to survivors.
- Changes in P-SEP levels over time (approximately 4 days) differed significantly between survivors and non-survivors, suggesting dynamic monitoring value.
Conclusions:
- Thrombomodulin (TM) and serial measurements of presepsin (P-SEP) may be valuable tools for predicting mortality in COVID-19 patients.
- Adjusted P-SEP and TM levels demonstrate potential as independent predictive markers for COVID-19 prognosis, separate from renal function.
- These biomarkers offer insights into the pathophysiological processes, including sepsis and endothelial dysfunction, contributing to severe COVID-19 outcomes.
Abstract:
Coronavirus disease (COVID-19) has caused extensive mortality globally; therefore, biomarkers predicting the severity and prognosis of COVID-19 are essential. This study aimed to evaluate the application of presepsin (P-SEP) and thrombomodulin (TM), which are biomarkers of sepsis and endothelial dysfunction, respectively, in the prognosis of COVID-19. Serum P-SEP and TM levels from COVID-19 patients (n = 183) were measured. Disease severity was classified as mild, moderate I, moderate II, or severe based on hemoglobin oxygen saturation and the history of intensive care unit transfer or use of ventilation at admission. Patients in the severe group were further divided into survivors and non-survivors. P-SEP and TM levels were significantly higher in the severe group than those in the mild group, even after adjusting for creatinine values. In addition, TM levels were significantly higher in non-survivors than in survivors. Changes in the P-SEP levels at two time points with an interval of 4.1 ± 2.2 days were significantly different between the survivors and non-survivors. In conclusion, TM and continuous P-SEP measurements may be useful for predicting mortality in patients with COVID-19. Moreover, our data indicate that P-SEP and TM values after creatinine adjustment could be independent predictive markers, apart from renal function.
More Related Videos
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...