Mortality risk in survivors of acute COVID-19 and the urinary proteome: Follow-up results from a multinational study that prospectively evaluated a proteomic urine test for early and accurate prognosis of critical course complications in patients with SARS-CoV-2 infection (CRIT-COV-U)

Abstract

AbstractSurvival prospects following SARS-CoV-2 infection extend beyond the acute phase, influenced by various factors including age, health conditions, and infection severity. We investigated mortality risk among 651 post-acute COVID-19 patients, assessing the association between urinary peptides and future death. Data spanning until December 2023 were collected from six countries, comparing mortality trends with age- and sex-matched non-infected controls. A death prediction classifier was developed and validated using pre-existing urinary peptidomics datasets. Notably, 13.98% of post-COVID-19 patients succumbed during the follow-up, with mortality rates significantly higher than non-infected controls, particularly evident in younger individuals (<65 years). Urinary peptide analysis identified 201 peptides linked to mortality, integrated into a predictive classifier (DP201). Higher DP201 scores, alongside age and BMI, significantly predicted death. These findings underscore the utility of urinary peptides in prognosticating post-acute COVID-19 mortality, offering insights for targeted interventions.