Extended use of suPAR at Hvidovre University Hospital due to COVID-19

By: Ove Andersen, MD, PhD, DmSc, Copenhagen University Hospital Hvidovre, Denmark

Our hospital was the first to implement suPAR as a routine marker for acute medical patients in 2013. Since then more than 50,000 suPAR measurements have been carried out. It has become clear that suPAR is a very strong prognostic marker, exceeding the prognostic value of all other routinely measured biomarkers in our hospital. suPAR is associated with the risk of readmission and mortality in patients regardless of the disease in question.

Recently, we have published a paper showing suPAR as an independent marker of readmission and mortality in patients with chronic obstructive lung disease. As we and others previously have shown, suPAR is also a strong prognostic marker of disease severity in viral diseases. We, therefore, speculate that suPAR may be a highly suitable marker for patients with COVID-19, a viral disease that affects the lungs.

Before COVID-19, we measured suPAR using the suPARnostic® ELISA technology. But in COVID-19 disease, fast risk triaging has become immensely important as the flow of patients is high. We need to quickly decide whether to discharge the patient to home quarantine, or admit to the hospital. The latter, in the case the patient might develop a severe disease with need of oxygen supplementation and high level of care.

To get fast and additional knowledge to support the decision of home quarantine or hospital admission, we therefore implemented the suPARnostic® Quick Triage point-of-care technology, which allows us to obtain suPAR levels within 20-30 minutes of blood drawing. We do this 24/7.

“It has become clear that suPAR is a very strong prognostic marker, exceeding the prognostic value of all other routinely measured biomarkers in our hospital.” Prof. Ove Andersen

Although it is early times, the preliminary results look very convincing. Patients who do well have low suPAR, whereas patients who end up requiring admission to the ICU have high suPAR levels. We intend to do the statistical analysis in mid-April and submit our data for publication at the end of April (patients followed for 14 days after admission suPAR).

We are also part of an international consortium on suPAR in COVID-19 which in addition to our hospital includes The Netherlands (Erasmus University Medical Center in Rotterdam), UK (Bristol), Germany (Charité, Berlin and Aachen University Hospital), Greece (Attikon University Hospital, Athens), and USA (Rush University Hospital, IL and University of Michigan, MI). This consortium is established to follow patients for 30 days after their initial presentation at a COVID-19 treatment center.

suPAR seems to be the perfect marker for risk stratification in COVID-19, and we are very excited to soon have the results. If positive, suPAR can be a strong tool for the much-needed early risk stratification of patients with COVID-19.

Read this article and many more in our 3rd issue of suPAR News, out June 25!