Searching for New Biomarkers to Assess COVID-19 Patients: A Pilot Study

Area of Science:

• Biochemistry
• Medical Diagnostics
• Pathophysiology

Background:

• Assessing patient severity in urgent conditions, including infectious diseases, requires rapid evaluation.
• Derived indices offer better characterization of complex syndromes than individual indicators.
• Butyrylcholinesterase (BChE) activity is decreased, and von Willebrand factor (vWF) secretion is increased in COVID-19 patients, contributing to thrombosis.

Purpose of the Study:

• To determine vWF concentration and activity in COVID-19 patients.
• To identify novel diagnostic indices for predicting COVID-19 mortality.
• To compare the prognostic values of individual and newly derived indices.

Main Methods:

• Retrospective analysis of COVID-19 patients (survivors n=77, deceased n=24).
• Measurement of BChE activity, malondialdehyde (MDA), and vWF antigen (AGWF) and activity (ActWF).
• Derivation and evaluation of new diagnostic indices using biochemical markers.

Main Results:

• vWF antigen levels were 1.5-fold higher in deceased patients compared to survivors.
• Indices incorporating vWF antigen levels outperformed those using vWF activity.
• The index [Urea] × [AGWF] × 1000/(BChEb × [ALB]) demonstrated superior discriminatory power for mortality prediction (AUC = 0.91).
• The index [Urea] × 1000/(BChEb × [ALB]) also showed good predictive value (AUC = 0.95).

Conclusions:

• The derived index [Urea] × [AGWF] × 1000/(BChEb × [ALB]) is a highly effective predictor of COVID-19 mortality.
• This index, along with [Urea] × 1000/(BChEb × [ALB]), warrants further validation for potential use in diagnostic laboratories.