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Diagnostic and Prognostic Value of SCUBE-1 in COVID-19 Patients
Vildan Ozer1, Ozgen Gonenc Cekic2, Ozlem Bulbul1
1Karadeniz Technical University, School of Medicine, Department of Emergency Medicine, Trabzon, Türkiye.
Insights
Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) levels can help differentiate COVID-19 patients and predict disease severity. Higher SCUBE-1 levels correlate with more severe illness, potentially aiding in hospitalization decisions.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Background:
- The COVID-19 pandemic significantly increased physician workload and highlighted the need for accurate diagnostic and prognostic markers.
- Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1), found in platelets and endothelial cells, is implicated in inflammatory and thrombotic processes relevant to COVID-19.
Purpose of the Study:
- To investigate the diagnostic utility of SCUBE-1 levels in patients suspected of having COVID-19.
- To determine the correlation between SCUBE-1 levels and COVID-19 disease severity.
- To assess the potential of SCUBE-1 as a biomarker for guiding hospitalization and discharge decisions.
Main Methods:
- A cohort of 332 patients (252 COVID-19 positive, 80 COVID-19 negative) were analyzed retrospectively.
- SCUBE-1 levels were measured and compared between COVID-19 positive and negative groups.
- COVID-19 positive patients were categorized by disease severity (mild, moderate, severe, critical) and SCUBE-1 levels were correlated with these categories.
Main Results:
- SCUBE-1 levels were significantly higher in COVID-19 positive patients (8.48 ± 7.42 ng/mL) compared to COVID-19 negative patients (1.86 ± 0.92 ng/mL) (P < 0.001).
- A strong positive correlation was observed between SCUBE-1 levels and COVID-19 severity: mild (3.20 ± 1.65 ng/mL), moderate (4.78 ± 2.26 ng/mL), severe (13.68 ± 3.95 ng/mL), and critical (21.87 ± 5.39 ng/mL) (P < 0.001).
- Initial SCUBE-1 levels were significantly lower in discharged patients compared to those requiring ward or ICU admission.
Conclusions:
- SCUBE-1 levels effectively differentiate between patients with and without COVID-19.
- SCUBE-1 levels demonstrate a significant correlation with the severity of COVID-19 illness.
- SCUBE-1 shows promise as a biomarker for assessing disease severity and informing clinical management decisions in COVID-19 patients.
Introduction:
The workload of physicians increased due to the number of patients presenting with suspicion of coronavirus 2019 (COVID-19) and the prolonged wait times in the emergency department during the COVID-19 pandemic. Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) is a protein present in platelets and endothelial cells; it is activated by inflammation from COVID-19 and may be associated with COVID-19's known thrombotic risk. We aimed to determine whether SCUBE-1 levels are diagnostically correlated in suspected COVID-19 patients, and whether SCUBE-1 correlated with severity of disease and, therefore, might be useful to guide hospitalization/discharge decisions.
Methods:
The suspected COVID-19 patients cared for at tertiary healthcare institutions for one year between May 2021-May 2022 were examined in this study. The subjects were both suspected COVID-19 patients not ultimately found to have COVID-19 and those who were diagnosed with COVID-19. By modifying the disease severity scoring systems present in COVID-19 guidelines in 2021, the COVID-19-positive patient group was classified as mild, moderate, severe, and critical, and compared using the SCUBE-1 levels. Moreover, SCUBE-1 levels were compared between the COVID-19 positive group and the COVID-19 negative group.
Results:
A total of 507 patients were considered for the present study. After excluding 175 patients for incomplete data and alternate comorbid organ failure. we report on 332 patients (65.5%). Of these 332 patients, 80 (24.0%) were COVID-19 negative, and 252 (76.0%) were COVID-19 positive. Of 252 (100%) patients diagnosed with COVID-19, 74 (29.4%) were classified as mild, 95 (37.7%) moderate, 45 (17.8%) severe, and 38 (15.1%) critical. The SCUBE-1 levels were statistically different between COVID-19 positive (8.48 ± 7.42 nanograms per milliliter [ng/mL]) and COVID-19 negative (1.86 ± 0.92 ng/mL) patients (P < 0.001). In the COVID-19 positive group, SCUBE-1 levels increased with disease severity (mild = 3.20 ± 1.65 ng/mL, moderate = 4.78 ± 2.26 ng/mL, severe = 13.68 ± 3.95 ng/mL, and critical = 21.87 ± 5.39 ng/mL) (P < 0.001). The initial SCUBE-1 levels of discharged patients were significantly lower than those requiring hospitalization (discharged = 2.89 ng/mL [0.55-8.60 ng/mL]; ward admitted = 7.13 ng/mL [1.38-21.29 ng/mL], and ICU admitted = 21.19 ng/mL [10.58-37.86 ng/mL]) (P < 0.001).
Conclusion:
The SCUBE-1 levels were found to be differentiated between patients with and without COVID-19 and to be correlated with the severity of illness.
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