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

2022; BioMed Central; Volume: 23; Issue: 1 Linguagem: Inglês

10.1186/s12931-022-02220-5

1465-993X

Lee Butcher, Jun-Cezar Zaldua, José Antonio Carranza Carnicero, Karl Hawkins, Janet Whitley, R. Mothukuri, Phillip Evans, Keith Morris, Suresh Pillai, Jorge D. Erusalimsky,

Respiratory Support and Mechanisms

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.