Efficacy of copeptin in distinguishing COVID‐19 pneumonia from community‐acquired pneumonia

Abstract

The clinical symptoms of community-acquired pneumonia (CAP) and coronavirus disease 2019 (COVID-19)-associated pneumonia are similar. Effective predictive markers are needed to differentiate COVID-19 pneumonia from CAP in the current pandemic conditions. Copeptin, a 39-aminoacid glycopeptide, is a C-terminal part of the precursor pre-provasopressin (pre-proAVP). The activation of the AVP system stimulates copeptin secretion in equimolar amounts with AVP. This study aims to determine serum copeptin levels in patients with CAP and COVID-19 pneumonia and to analyze the power of copeptin in predicting COVID-19 pneumonia. The study consists of 98 patients with COVID-19 and 44 patients with CAP. The basic demographic and clinical data of all patients were recorded, and blood samples were collected. The receiver operating characteristic (ROC) curve was generated and the area under the ROC curve (AUC) was measured to evaluate the discriminative ability. Serum copeptin levels were significantly higher in COVID-19 patients compared to CAP patients (10.2 ± 4.4 ng/ml and 7.1 ± 3.1 ng/ml; p < .001).

Improvement of outcome prediction of hospitalized patients with COVID-19 by a dual marker strategy using high-sensitive cardiac troponin I and copeptin

“…Our data show that copeptin levels were increased in hospitalized patients with COVID-19, as the median levels (19.5 pmol/L, IQR 8.9–46.7) were above the established normal values of a healthy population (median of 4.2 pmol/L, IQR 1–13.8 pmol/L). To date, only one study has published data on copeptin measurements in patients with COVID-19 pneumonia ( n = 98) and found significantly increased values compared to patients with non-COVID-19 pneumonia [ 14 ].…”

“…There is currently no research data available evaluating the prognostic performance of copeptin in COVID-19. Evidence from one small, retrospective study, however, suggested that raised values of copeptin facilitated differential diagnosis of patients with COVID-19 pneumonia from those with non-COVID-19 pneumonia [ 14 ].…”

Vasopressin and Breathing: Review of Evidence for Respiratory Effects of the Antidiuretic Hormone

“…Finally, some studies also indicate the potential role of copeptin in the diagnosis and risk stratification of patients with pulmonary hypertension ( Nickel et al, 2013 ) and pulmonary embolisms ( Hellenkamp et al, 2018 ). Recently, it has been shown that elevated concentrations of copeptin are associated with worse outcome in COVID-19 patients with SARS-CoV-2 infection ( Gregoriano et al, 2021 ) and may discriminate between patients with COVID-19 and patients with community-acquired pneumonia ( Kuluöztürk et al, 2021 ).…”

Copeptin and Stress

“…Latest evidence suggests copeptin could be a promising biomarker in distinguishing the novel oronavirus disease-19 (COVID-19) pneumonia from CAP, albeit with substantial limitations [67]: in a small cohort of non-critical patients, indeed, copeptin levels were found to be higher in COVID-19 pneumonia than in CAP (10.2 vs. 7.1 ng/mL, p < 0.001), being also the best independent predictor of COVID-19 pneumonia (OR 1.183 95% CI 1.033-1.354 p = 0.015) with reasonable accuracy at a cut-off of 6.83 ng/mL (AUC 0.764).…”