Scientists find early predictor of severe breathing failure in COVID-19

In a new study, researchers found that a very high level of a protein known as suPAR in the blood of patients with COVID-19 may be a predictor of severe respiratory failure.

The findings suggest suPAR could be a potential predictor for which patients with COVID-19 will need to be put on ventilators to help them breathe.

The research was conducted by a team at Rush University Medical Center and other institutions.

Soluble urokinase plasminogen activator receptor, aka suPAR, is produced in the endobronchial tree in the lungs and by immune cells in the bone marrow and repeatedly has been shown to harm kidneys.

Previous research has shown that chronically elevated blood levels are linked to the development of chronic kidney disease, yet a high plasma suPAR also increases the risk for acute kidney injury—a sudden decline in kidney function that can be a severe side effect of general medical procedures.

Reportedly, an increasing number of patients with severe COVID-19 also develop kidney problems, which is leading researchers to investigate the connection between COVID-19, suPAR and kidney disease.

The research team tested suPAR levels in 15 patients when they were admitted or tested for COVID-19. They measured 57 patients for suPAR and followed them in their clinical course.

Time to intubation was followed and found to be shorter in patients with a higher plasma suPAR.

Previous research has shown that suPAR is linked to poor outcomes from acute respiratory distress syndrome (a condition in many patients with severe COVID-19) and poor lung functioning in critically ill patients.

The link between suPAR and respiratory failure suggests a way to help manage patients with COVID-19.

The team says If we measure suPAR as part of diagnosing COVID-19, we may know whom to watch more and whom to send home.

Plasma suPAR levels give scientists a window into the course of the disease, allowing for improved monitoring and applying new and supportive treatments early.

The findings of the present research raise additional new questions about a role for suPAR in COVID-19-associated organ dysfunction.

One author of the study is Jochen Reiser, MD, Ph.D., the Ralph C. Brown, MD, Professor of Internal Medicine, chairperson of the Department of Internal Medicine at Rush.

The study is published in Critical Care.

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