EASIX for Prediction of Outcome in Hospitalized SARS-CoV-2 Infected Patients

EASIX for Prediction of Outcome in Hospitalized SARS-CoV-2 Infected Patients

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BackgroundThe coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has evoked a pandemic that challenges public health-care systems worldwide.Endothelial cell dysfunction plays a key role in pathophysiology, and Mains Plug Top simple prognosticators may help to optimize allocation of limited resources.Endothelial activation and stress index (EASIX) is a validated predictor of endothelial complications and outcome after allogeneic stem cell transplantation.Aim of this study was to test if EASIX could predict life-threatening complications in patients with COVID-19.

MethodsSARS-CoV-2-positive, hospitalized patients were enrolled onto a prospective non-interventional register study (n=100).Biomarkers were assessed at hospital admission.Primary endpoint was severe course of disease (mechanical ventilation and/or death, V/D).Results were validated in 126 patients treated in two independent institutions.

ResultsEASIX at admission was a strong predictor of severe course of the disease (odds ratio for a two-fold change 3.4, 95%CI 1.8-6.3, p<0.

001), time to V/D (hazard ratio (HR) for a two-fold change 2.0, 95%CI 1.5-2.6, p<0.

001) as Jars well as survival (HR for a two-fold change 1.7, 95%CI 1.2-2.5, p=0.

006).The effect was retained in multivariable analysis adjusting for age, gender, and comorbidities and could be validated in the independent cohort.At hospital admission EASIX correlated with increased suppressor of tumorigenicity-2, soluble thrombomodulin, angiopoietin-2, CXCL8, CXCL9 and interleukin-18, but not interferon-alpha.ConclusionEASIX is a validated predictor of COVID19 outcome and an easy-to-access tool to segregate patients in need for intensive surveillance.