| Title: |
Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19. |
| Authors: |
Van Singer, Mathias, Brahier, Thomas, Koch, Jana, Hugli, Pr. Olivier, Weckman, Andrea M., Zhong, Kathleen, Kain, Taylor J., Leligdowicz, Aleksandra, Bernasconi, Enos, Ceschi, Alessandro, Parolari, Sara, Vuichard-Gysin, Danielle, Kain, Kevin C., Albrich, Werner C., Boillat-Blanco, Noémie |
| Source: |
BMC Infectious Diseases; 9/26/2023, Vol. 23 Issue 1, p1-8, 8p |
| Subject Terms: |
INTERLEUKIN-6, CLINICAL decision support systems, COVID-19, RANDOMIZED controlled trials, ALGORITHMS |
| Geographic Terms: |
LAUSANNE (Switzerland) |
| Abstract: |
Background: A prospective observational cohort study of COVID-19 patients in a single Emergency Department (ED) showed that sTREM-1- and IL-6-based algorithms were highly predictive of adverse outcome (Van Singer et al. J Allergy Clin Immunol 2021). We aim to validate the performance of these algorithms at ED presentation. Methods: This multicentric prospective observational study of PCR-confirmed COVID-19 adult patients was conducted in the ED of three Swiss hospitals. Data of the three centers were retrospectively completed and merged. We determined the predictive accuracy of the sTREM-1-based algorithm for 30-day intubation/mortality. We also determined the performance of the IL-6-based algorithm using data from one center for 30-day oxygen requirement. Results: 373 patients were included in the validation cohort, 139 (37%) in Lausanne, 93 (25%) in St.Gallen and 141 (38%) in EOC. Overall, 18% (93/373) patients died or were intubated by day 30. In Lausanne, 66% (92/139) patients required oxygen by day 30. The predictive accuracy of sTREM-1 and IL-6 were similar compared to the derivation cohort. The sTREM-1-based algorithm confirmed excellent sensitivity (90% versus 100% in the derivation cohort) and negative predictive value (94% versus 100%) for 30-day intubation/mortality. The IL-6-based algorithm performance was acceptable with a sensitivity of 85% versus 98% in the derivation cohort and a negative predictive value of 60% versus 92%. Conclusion: The sTREM-1 algorithm demonstrated good reproducibility. A prospective randomized controlled trial, comparing outcomes with and without the algorithm, is necessary to assess its safety and impact on hospital and ICU admission rates. The IL-6 algorithm showed acceptable validity in a single center and need additional validation before widespread implementation. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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