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    Can copeptin predict the severity of coronavirus disease 2019 infection?
    (Associação Médica Brasileira, 2021) İn, Erdal; Kuluöztürk, Mutlu; Telo, Selda; Toraman, Zülal Aşçı; Karabulut, Ercan
    Objetive: Coronavirus disease 2019 (COVID-19) has quickly turned into a health problem globally. Early and effective predictors of disease severity are needed to improve the management of the patients affected with COVID-19. Copeptin, a 39-amino acid glycopeptide, is known as a C-terminal unit of the precursor pre-provasopressin (pre-proAVP). Activation of AVP system stimulates copeptin secretion in equimolar amounts with AVP. This study aimed to determine serum copeptin levels in the patients with COVID-19 and to examine the relationship between serum copeptin levels and the severity of the disease. Methods: The study included 90 patients with COVID-19. The patients with COVID-19 were divided into two groups according to disease severity as mild/moderate disease (n=35) and severe disease (n=55). All basic demographic and clinical data of the patients were recorded and blood samples were collected. Results: Copeptin levels were significantly higher in the patients with severe COVID-19 compared with the patients with mild/moderate COVID-19 (p<0.001). Copeptin levels were correlated with ferritin and fibrinogen levels positively (r=0.32, p=0.002 and r=0.25, p=0.019, respectively), and correlated with oxygen saturation negatively (r=-0.37, p<0.001). In the multivariate logistic regression analysis, it was revealed that copeptin (OR: 2.647, 95%CI 1.272-5.510; p=0.009) was an independent predictor of severe COVID-19 disease. A cutoff value of 7.84 ng/mL for copeptin predicted severe COVID-19 with a sensitivity of 78% and a specificity of 80% (AUC: 0.869, 95%CI 0.797-0.940; p<0.001). Conclusion: Copeptin could be used as a favorable prognostic biomarker while determining the disease severity in COVID-19.
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    Efficacy of copeptin in distinguishing COVID-19 pneumonia from community-acquired pneumonia
    (wıley, 2021) Kuluozturk, Mutlu; Telo, Selda; Karabulut, Ercan
    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.