Mon Sep 05 2022

Soluble urokinase Plasminogen Activator Receptor (suPAR) levels are predictive of COVID-19 severity: an Italian experience


Research links higher suPAR levels to increased severity of COVID-19 and influences patient survival rates, underscoring its effectiveness as a prognostic biomarker for assessing disease risk. This connection indicates that elevated suPAR levels could forecast more severe disease progression. Such insights provide healthcare professionals with a crucial tool for evaluating patient risks more accurately and shaping targeted treatment plans. This utility of suPAR levels as a predictive marker not only aids in early risk identification but also enhances the strategic approach towards managing COVID-19, offering a pathway to optimize patient outcomes through informed decision-making.


The soluble urokinase Plasminogen Activator Receptor (suPAR) stands out as a reliable marker for determining COVID-19 severity, playing a key role in tailoring treatments for the disease. This study focuses on exploring how suPAR levels relate to the severity of COVID-19 symptoms and compares these findings to those from traditional inflammatory markers. By examining the link between suPAR concentrations and COVID-19 intensity, the research aims to enhance our ability to use suPAR alongside conventional markers. This approach promises to improve the accuracy of disease outcome predictions and personalize treatment strategies for COVID-19 patients.


Researchers tested the sera of 71 COVID-19 patients for suPAR levels using the Chorus suPAR assay (Diesse Diagnostica Senese SpA, Italy). They compared suPAR levels with other inflammatory markers, including IL-1β, IL-6, TNF-α, circulating calprotectin, neutrophil and lymphocyte counts, and the Neutrophil/Lymphocyte Ratio (NLR). They used respiratory failure, measured by the P/F ratio, and mortality rates as measures of disease severity.


Studies have demonstrated a positive correlation between suPAR levels and several inflammation markers: IL-6 (r = 0.479, p = 0.000), TNF-α (r = 0.348, p = 0.003), circulating calprotectin (r = 0.369, p = 0.002), neutrophil counts (r = 0.447, p = 0.001), and NLR (r = 0.492, p = 0.001). By dividing the COVID-19 population based on suPAR concentrations—above and below 6 ng/mL—we found those with higher suPAR levels had significantly increased circulating calprotectin (10.1 μg/mL, SD 7.9 vs 6.4 μg/mL, SD 7.5, p < 0.001), reduced P/F ratios (207.5 IQR 188.3 vs 312.0 IQR 127.8, p = 0.013), and a higher mortality rate. Additionally, COVID-19 patients requiring extra respiratory support (like Nasal Cannula, Venturi Mask, BPAP, and CPAP) exhibited higher median suPAR levels (6.5 IQR = 4.9) compared to those on room air (4.6 IQR = 4.2).


published suPAR studies in leading medical journals

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