Presepsin value predicts the risk of developing severe/critical COVID-19 illness: results of a pooled analysis
The measurement of sepsis biomarkers represents now a cornerstone in risk assessment of patients with severe in- fectious diseases and/or sepsis, as they can help both predicting clinical progression and guiding therapeutic management [1]. Presepsin, also known as soluble CD14 subtype (sCD14-ST), is a glycoprotein fragment mainly synthesized and released by cells of the monocyte-macrophage lineage in response to a vast array of infections [2]. As opposed to other conventional sepsis biomarkers, namely procalcitonin, one theoretical advantage of measuring presepsin in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is that its circulating value may directly reflect the clinical severity of coronavirus disease 2019 (COVID-19) rather than solely mirroring the presence of co- or super-bacterial infections, which occur at high frequency (up to 34%) in COVID-19 patients with severe or critical conditions [3]. It has also been reported that fungal co- and super-infections may complicate the clinical course in up to 12% of COVID-19 patients, while the burden of viral co- and super- infections may also be as high as 15% [4], with both con- ditions associated with an over 3-fold higher risk of death.