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High levels of soluble RAGE are associated with a greater risk of mortality in COVID-19 patients treated with dexamethasone

Lee Butcher, Jun-Cezar Zaldua Orcid Logo, Jose A. Carnicero, Karl Hawkins Orcid Logo, Janet Whitley, Rangaswamy Mothukuri, Adrian Evans Orcid Logo, Keith Morris, Suresh Pillai, Jorge D. Erusalimsky

Respiratory Research, Volume: 23, Issue: 1

Swansea University Authors: Jun-Cezar Zaldua Orcid Logo, Karl Hawkins Orcid Logo, Adrian Evans Orcid Logo

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Abstract

Blood levels of the soluble receptor for advanced glycation end-products (sRAGE) are acutely elevated during the host inflammatory response to infection and predict mortality in COVID-19. However, the prognostic performance of this biomarker in the context of treatments to reduce inflammation is unc...

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Published in: Respiratory Research
ISSN: 1465-993X
Published: Springer Science and Business Media LLC 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa62071
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Abstract: Blood levels of the soluble receptor for advanced glycation end-products (sRAGE) are acutely elevated during the host inflammatory response to infection and predict mortality in COVID-19. However, the prognostic performance of this biomarker in the context of treatments to reduce inflammation is unclear. In this study we investigated the association between sRAGE and mortality in dexamethasone-treated COVID-19 patients. We studied 89 SARS-CoV-2 positive subjects and 22 controls attending the emergency department of a University Teaching Hospital during the second wave of COVID-19 and measured sRAGE at admission. In positive individuals sRAGE increased with disease severity and correlated with the National Early Warning Score 2 (Pearson’s r = 0.56, p < 0.001). Fourteen out of 72 patients treated with dexamethasone died during 28 days of follow-up. Survival rates were significantly lower in patients with high sRAGE (> 3532 pg/mL) than in those with low sRAGE (p = 0.01). Higher sRAGE levels were associated with an increased risk of death after adjustment for relevant covariates. In contrast, IL-6 did not predict mortality in these patients. These results demonstrate that sRAGE remains an independent predictor of mortality among COVID-19 patients treated with dexamethasone. Determination of sRAGE could be useful for the clinical management of this patient population.
Keywords: Mortality, Prognostic, Biomarkers, sRAGE, IL-6, NEWS2, Dexamethasone, COVID-19, SARS-CoV-2
College: Faculty of Medicine, Health and Life Sciences
Funders: This study was supported by Sêr Cymru GOV.WALES
Issue: 1