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Background <p>Biomarkers based on host response signatures are currently under development for the critically ill. We applied a 29-mRNA classifier for the diagnosis and prognosis of suspected acute infection and sepsis (TriVerity<sup>™</sup>, Inflammatix Inc.) in patients hospitalized with COVID-19.</p> Methods <p>We applied three scores from locked classifiers (IMX-BVN-4 and IMX-SEV-4) from the 29-mRNA TriVerity<sup>™</sup> blood test in participants of the SAVE-MORE randomized clinical trial (ClinicalTrials.gov NCT04680949) at baseline and days 4 and 7 of treatment, to classify bacterial infection, viral infection and decompensation. Participants were adults hospitalized with confirmed COVID-19 pneumonia and plasma soluble urokinase plasminogen activator receptor (suPAR) levels of ≥ 6&#xa0;ng/ml, randomized to placebo or anakinra treatment.</p> Results <p>A total of 471 patients were studied. At baseline nearly 90% had a Very Low or Low IMX-BVN-4 Bacterial Score and Moderate, High or Very High IMX-BVN-4 Viral Score. Anakinra treatment had an effect on the expression of genes indicating IMX-SEV-4 High or Very High scores after a 7&#xa0;day treatment compared to baseline (12.9% of anakinra-treated patients continued being classified as high severity vs 20.4% of placebo-treated patients, p 0.046).</p> Conclusions <p>The classifiers were well tested in COVID-19 pneumonia and may become a useful tool for hospitalized patients.</p>

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29-mRNA host response signatures for classification of bacterial infection, viral infection and disease progression in COVID-19 pneumonia: a post hoc analysis of the SAVE-MORE randomized clinical trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月30日

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  • Evdoxia Kyriazopoulou,
  • Antigone Kotsaki,
  • Asimina Safarika,
  • Garyfallia Poulakou,
  • Haralampos Milionis,
  • Simeon Metallidis,
  • Georgios Adamis,
  • Archontoula Fragkou,
  • Aggeliki Rapti,
  • Pierluigi Del Vecchio,
  • Ioannis Kalomenidis,
  • Danae Kitzoglou,
  • Andrea Angheben,
  • Ilias Kainis,
  • Konstantina Iliopoulou,
  • Francesco Saverio Serino,
  • Petros Bakakos,
  • Vassiliki Tzavara,
  • Sofia Ioannou,
  • Lorenzo Dagna,
  • Katerina Dimakou,
  • Glykeria Tzatzagou,
  • Maria Chini,
  • Matteo Bassetti,
  • Vasileios Kotsis,
  • George Tsoukalas,
  • Carlo Selmi,
  • Sofia Nikolakopoulou,
  • Michael Samarkos,
  • Michael Doumas,
  • Aikaterini Masgala,
  • Ilias Papanikolaou,
  • Aikaterini Argyraki,
  • Karolina Akinosoglou,
  • Styliani Symbardi,
  • Periklis Panagopoulos,
  • George N. Dalekos,
  • Oliver Liesenfeld,
  • Timothy E. Sweeney,
  • Purvesh Khatri,
  • Evangelos J. Giamarellos-Bourboulis

摘要

Background

Biomarkers based on host response signatures are currently under development for the critically ill. We applied a 29-mRNA classifier for the diagnosis and prognosis of suspected acute infection and sepsis (TriVerity™, Inflammatix Inc.) in patients hospitalized with COVID-19.

Methods

We applied three scores from locked classifiers (IMX-BVN-4 and IMX-SEV-4) from the 29-mRNA TriVerity™ blood test in participants of the SAVE-MORE randomized clinical trial (ClinicalTrials.gov NCT04680949) at baseline and days 4 and 7 of treatment, to classify bacterial infection, viral infection and decompensation. Participants were adults hospitalized with confirmed COVID-19 pneumonia and plasma soluble urokinase plasminogen activator receptor (suPAR) levels of ≥ 6 ng/ml, randomized to placebo or anakinra treatment.

Results

A total of 471 patients were studied. At baseline nearly 90% had a Very Low or Low IMX-BVN-4 Bacterial Score and Moderate, High or Very High IMX-BVN-4 Viral Score. Anakinra treatment had an effect on the expression of genes indicating IMX-SEV-4 High or Very High scores after a 7 day treatment compared to baseline (12.9% of anakinra-treated patients continued being classified as high severity vs 20.4% of placebo-treated patients, p 0.046).

Conclusions

The classifiers were well tested in COVID-19 pneumonia and may become a useful tool for hospitalized patients.