Presepsin Predicts Severity and Secondary Bacterial Infection in COVID-19 by Bioinformatics Analysis

Abstract

Introduction. Novel coronavirus pneumonia (COVID-19) is an acute respiratory disease caused by the novel coronavirus SARS-CoV-2. Severe and critical illness, especially secondary bacterial infection (SBI) cases, accounts for the vast majority of COVID-19-related deaths. However, the relevant biological indicators of COVID-19 and SBI are still unclear, which significantly limits the timely diagnosis and treatment. Methods. The differentially expressed genes (DEGs) between severe COVID-19 patients with SBI and without SBI were screened through the analysis of GSE168017 and GSE168018 datasets. By performing Gene Ontology (GO) enrichment analysis for significant DEGs, significant biological processes, cellular components, and molecular functions were selected. To understand the high-level functions and utilities of the biological system, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed. By analyzing protein-protein interaction (PPI) and key subnetworks, the core DEGs were found. Results. 85 DEGs were upregulated, and 436 DEGs were downregulated. The CD14 expression was significantly increased in the SBI group of severe COVID-19 patients ( P < 0.01 ). The area under the curve (AUC) of CD14 in the SBI group in severe COVID-19 patients was 0.9429. The presepsin expression was significantly higher in moderate to severe COVID-19 patients ( P < 0.05 ). Presepsin has a diagnostic value for moderate to severe COVID-19 with the AUC of 0.9732. The presepsin expression of COVID-19 patients in the nonsurvivors was significantly higher than that in the survivors ( P < 0.05 ). Conclusion. Presepsin predicts severity and SBI in COVID-19 and may be associated with prognosis in COVID-19.

Presepsin as a prognostic biomarker in COVID-19 patients: combining clinical scoring systems and laboratory inflammatory markers for outcome prediction

“…Recent metaanalysis studie have indicated that Presepsin is a promising biomarker that can accurately reflect the severity of COVID-19 [25]. Since the outbreak of the novel coronavirus in 2020, studies have found that Presepsin levels are higher in hospitalized patients who died compared to those who survived [21,39,40]. Presepsin levels have also been found to correlate with the need for ICU admission, ICU length of stay, and total hospital stay.…”

The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers

“…A significant threshold variation persists across studies. Although presepsin is recognized as an indicator of sepsis, recent studies have been published exploring its relationship with infectious diseases [39][40][41][42][43][44][45]. The defined cutoff value of 600 pg/mL was established for bacterial infectious diseases [36].…”

The Role of Toll-like Receptor-4 in Macrophage Imbalance in Lethal COVID-19 Lung Disease, and Its Correlation with Galectin-3

“…In response to viral infections, also without co-infections and even more in those with bacterial co-infections, the marrow production of cellular elements of the monocytic-macrophage series may shift towards a pro-inflammatory or immunoregulatory phenotype according to phase progression and interaction with host immune system. On this point, recent evidences suggest that the alterations of the immune responses under the control of monocytes-macrophages are certainly one of the elements affecting the severity of SARS-CoV-2 infections [36][37][38][39].…”