Correlation between Serum Biomarkers and Lung Ultrasound in COVID-19: An Observational Study

Author:

Mousa Amne12ORCID,Blok Siebe G.23,Karssen Dian1,Aman Jurjan4,Annema Jouke T.4,Bogaard Harm Jan4ORCID,Bonta Peter I.4,Haaksma Mark E.12,Heldeweg Micah L. A.12,Lieveld Arthur W. E.5,Nanayakkara Prabath5,Nossent Esther J.4,Smit Jasper M.12,Smit Marry R.3,Vlaar Alexander P. J.3ORCID,Schultz Marcus J.3ORCID,Bos Lieuwe D. J.3,Paulus Frederique3,Tuinman Pieter R.12,

Affiliation:

1. Department of Intensive Care Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands

2. Amsterdam Leiden IC Focused Echography (ALIFE, www.alifeofpocus.com), 1081 HV Amsterdam, The Netherlands

3. Department of Intensive Care Medicine, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

4. Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands

5. Section Acute Medicine, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands

Abstract

Serum biomarkers and lung ultrasound are important measures for prognostication and treatment allocation in patients with COVID-19. Currently, there is a paucity of studies investigating relationships between serum biomarkers and ultrasonographic biomarkers derived from lung ultrasound. This study aims to assess correlations between serum biomarkers and lung ultrasound findings. This study is a secondary analysis of four prospective observational studies in adult patients with COVID-19. Serum biomarkers included markers of epithelial injury, endothelial dysfunction and immune activation. The primary outcome was the correlation between biomarker concentrations and lung ultrasound score assessed with Pearson’s (r) or Spearman’s (rs) correlations. Forty-four patients (67 [41–88] years old, 25% female, 52% ICU patients) were included. GAS6 (rs = 0.39), CRP (rs = 0.42) and SP-D (rs = 0.36) were correlated with lung ultrasound scores. ANG-1 (rs = −0.39) was inversely correlated with lung ultrasound scores. No correlations were found between lung ultrasound score and several other serum biomarkers. In patients with COVID-19, several serum biomarkers of epithelial injury, endothelial dysfunction and immune activation correlated with lung ultrasound findings. The lack of correlations with certain biomarkers could offer opportunities for precise prognostication and targeted therapeutic interventions by integrating these unlinked biomarkers.

Publisher

MDPI AG

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