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Background <p>Critical COVID-19 is associated with high mortality, and acute kidney injury (AKI) is common. Endostatin has emerged as a promising prognostic biomarker for predicting AKI and mortality in intensive care. This study aimed to investigate plasma endostatin at intensive care unit (ICU) admission as a biomarker for AKI, renal replacement therapy (RRT), and 90-day mortality in COVID-19.</p> Methods <p>A pre-planned retrospective analysis of a prospectively collected cohort of admissions with a primary SARS-CoV-2 infection to six ICUs in southern Sweden between May 2020 and May 2021 was undertaken. Endostatin at ICU admission was evaluated with multivariable logistic regression analyses adjusted for age, sex, C-reactive protein, and creatinine. Net reclassification index analyses were also performed.</p> Results <p>Four hundred eighty-four patients were included. Endostatin showed a non-linear association with AKI, RRT, and 90-day mortality. Endostatin levels of 100–200 ng/mL were associated with AKI on ICU day 1 (OR 5.1, 95% CI 1.5–18,<i> p</i>&#xa0;=&#xa0;0.0097), RRT during the ICU stay (OR 3.5, 95% CI 1.1–12,<i> p</i>&#xa0;=&#xa0;0.039), and 90-day mortality (OR 4.2, 95% CI 1.6–11,<i> p</i>&#xa0;=&#xa0;0.0037). Adding endostatin to creatinine improved prediction of AKI on ICU day 1, while adding it to a model containing age, sex, CRP, and creatinine improved prediction of both AKI on ICU day 1 and 90-day mortality, but not RRT.</p> Conclusions <p>Endostatin at ICU admission was independently associated with AKI, RRT, and 90-day mortality in ICU patients with COVID-19. In addition, endostatin improved the prediction of AKI and 90-day mortality, highlighting its potential as a biomarker for early risk stratification in intensive care.</p>

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Plasma endostatin at intensive care admission is independently associated with acute kidney injury, dialysis, and mortality in COVID-19

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月3日

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  • Hazem Koozi,
  • Jonas Engström,
  • Ahmad Zwawi,
  • Martin Spångfors,
  • Ingrid Didriksson,
  • Anders Larsson,
  • Hans Friberg,
  • Attila Frigyesi

摘要

Background

Critical COVID-19 is associated with high mortality, and acute kidney injury (AKI) is common. Endostatin has emerged as a promising prognostic biomarker for predicting AKI and mortality in intensive care. This study aimed to investigate plasma endostatin at intensive care unit (ICU) admission as a biomarker for AKI, renal replacement therapy (RRT), and 90-day mortality in COVID-19.

Methods

A pre-planned retrospective analysis of a prospectively collected cohort of admissions with a primary SARS-CoV-2 infection to six ICUs in southern Sweden between May 2020 and May 2021 was undertaken. Endostatin at ICU admission was evaluated with multivariable logistic regression analyses adjusted for age, sex, C-reactive protein, and creatinine. Net reclassification index analyses were also performed.

Results

Four hundred eighty-four patients were included. Endostatin showed a non-linear association with AKI, RRT, and 90-day mortality. Endostatin levels of 100–200 ng/mL were associated with AKI on ICU day 1 (OR 5.1, 95% CI 1.5–18, p = 0.0097), RRT during the ICU stay (OR 3.5, 95% CI 1.1–12, p = 0.039), and 90-day mortality (OR 4.2, 95% CI 1.6–11, p = 0.0037). Adding endostatin to creatinine improved prediction of AKI on ICU day 1, while adding it to a model containing age, sex, CRP, and creatinine improved prediction of both AKI on ICU day 1 and 90-day mortality, but not RRT.

Conclusions

Endostatin at ICU admission was independently associated with AKI, RRT, and 90-day mortality in ICU patients with COVID-19. In addition, endostatin improved the prediction of AKI and 90-day mortality, highlighting its potential as a biomarker for early risk stratification in intensive care.