Efficacy of copeptin in distinguishing COVID-19 pneumonia from community-acquired pneumonia
Künye
Kuluöztürk, M., İn, E., Telo, S., Karabulut, E., & Geçkil, A. A. (2021). Efficacy of copeptin in distinguishing COVID‐19 pneumonia from community‐acquired pneumonia. Journal of medical virology, 93(5), 3113-3121.Özet
The clinical symptoms of community‐acquired pneumonia (CAP) and coronavirus
disease 2019 (COVID‐19)‐associated pneumonia are similar. Effective predictive
markers are needed to differentiate COVID‐19 pneumonia from CAP in the current
pandemic conditions. Copeptin, a 39‐aminoacid glycopeptide, is a C‐terminal part of
the precursor pre‐provasopressin (pre‐proAVP). The activation of the AVP system
stimulates copeptin secretion in equimolar amounts with AVP. This study aims to
determine serum copeptin levels in patients with CAP and COVID‐19 pneumonia
and to analyze the power of copeptin in predicting COVID‐19 pneumonia. The study
consists of 98 patients with COVID‐19 and 44 patients with CAP. The basic
demographic and clinical data of all patients were recorded, and blood samples were
collected. The receiver operating characteristic (ROC) curve was generated and the
area under the ROC curve (AUC) was measured to evaluate the discriminative
ability. Serum copeptin levels were significantly higher in COVID‐19 patients
compared to CAP patients (10.2 ± 4.4 ng/ml and 7.1 ± 3.1 ng/ml; p < .001). Serum
copeptin levels were positively correlated with leukocyte, neutrophil, and platelet
count (r = −.21, p = .012; r = −.21, p = .013; r = −.20, p = .018; respectively). The multivariable logistic regression analysis revealed that increased copeptin (odds ratio
[OR] = 1.183, 95% confidence interval [CI], 1.033–1.354; p = .015) and CK‐MB
(OR = 1.052, 95% CI, 1.013–1.092; p = .008) levels and decreased leukocyte
count (OR = 0.829, 95% CI, 0.730–0.940; p = .004) were independent predictors
of COVID‐19 pneumonia. A cut‐off value of 6.83 ng/ml for copeptin predicted
COVID‐19 with a sensitivity of 78% and a specificity of 73% (AUC: 0.764% 95 Cl:
0.671–0.856, p < .001). Copeptin could be a promising and useful biomarker to be
used to distinguish COVID‐19 patients from CAP patients.