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A biomarker assay to risk-stratify patients with symptoms of respiratory tract infection.
Husain, Shahid; Sage, Andrew T; Del Sorbo, Lorenzo; Cypel, Marcelo; Martinu, Tereza; Juvet, Stephen C; Mariscal, Andrea; Wright, Julie; Chao, Bonnie T; Shamandy, Alaa A; Mousavi, S Hossein; Ma, Jin; Wang, Bo; Valero, Jerome; Liu, Mingyao; Landes, Megan; Balachandran, Sharaniyaa; Hudson, Kimberley; Ngai, Michelle; Capuano, Marialessia; Gelardi, Maria; Lupia, Enrico; Marinowic, Daniel R; Friedrich, Frederico O; Schmitz, Carine R R; Dos Santos, Leticya S M; Barbe-Tuana, Florencia M; Jones, Marcus H; Kain, Kevin C; Mazzulli, Tony; Sabbah, Sam; Keshavjee, Shaf.
Afiliação
  • Husain S; Division of Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Sage AT; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Del Sorbo L; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Cypel M; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Martinu T; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Juvet SC; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Mariscal A; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Wright J; Interdepartmental Division of Critical Care Medicine, Medical and Surgical Intensive Care Unit, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Chao BT; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Shamandy AA; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Mousavi SH; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Ma J; Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Wang B; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Valero J; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Liu M; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Landes M; Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Balachandran S; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Hudson K; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Ngai M; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Capuano M; Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Gelardi M; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Lupia E; Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Marinowic DR; Tropical Disease Unit, Department of Medicine, University of Toronto, Sandra Rotman Centre for Global Health, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
  • Friedrich FO; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Schmitz CRR; Department of Computer Science, University of Toronto, Toronto, ON, Canada.
  • Dos Santos LSM; Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Barbe-Tuana FM; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Jones MH; Biostatistics Research Unit, University Health Network, Toronto, ON, Canada.
  • Kain KC; Department of Computer Science, University of Toronto, Toronto, ON, Canada.
  • Mazzulli T; Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Sabbah S; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
  • Keshavjee S; Vector Institute, Toronto, ON, Canada.
Eur Respir J ; 60(6)2022 12.
Article em En | MEDLINE | ID: mdl-36104292
BACKGROUND: Patients who present to an emergency department (ED) with respiratory symptoms are often conservatively triaged in favour of hospitalisation. We sought to determine if an inflammatory biomarker panel that identifies the host response better predicts hospitalisation in order to improve the precision of clinical decision making in the ED. METHODS: From April 2020 to March 2021, plasma samples of 641 patients with symptoms of respiratory illness were collected from EDs in an international multicentre study: Canada (n=310), Italy (n=131) and Brazil (n=200). Patients were followed prospectively for 28 days. Subgroup analysis was conducted on confirmed coronavirus disease 2019 (COVID-19) patients (n=245). An inflammatory profile was determined using a rapid, 50-min, biomarker panel (RALI-Dx (Rapid Acute Lung Injury Diagnostic)), which measures interleukin (IL)-6, IL-8, IL-10, soluble tumour necrosis factor receptor 1 (sTNFR1) and soluble triggering receptor expressed on myeloid cells 1 (sTREM1). RESULTS: RALI-Dx biomarkers were significantly elevated in patients who required hospitalisation across all three sites. A machine learning algorithm that was applied to predict hospitalisation using RALI-Dx biomarkers had a mean±sd area under the receiver operating characteristic curve of 76±6% (Canada), 84±4% (Italy) and 86±3% (Brazil). Model performance was 82±3% for COVID-19 patients and 87±7% for patients with a confirmed pneumonia diagnosis. CONCLUSIONS: The rapid diagnostic biomarker panel accurately identified the need for inpatient care in patients presenting with respiratory symptoms, including COVID-19. The RALI-Dx test is broadly and easily applicable across many jurisdictions, and represents an important diagnostic adjunct to advance ED decision-making protocols.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções Respiratórias / COVID-19 Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções Respiratórias / COVID-19 Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article