AUTHOR=Luft Thomas , Wendtner Clemens-Martin , Kosely Florentina , Radujkovic Aleksandar , Benner Axel , Korell Felix , Kihm Lars , Bauer Matthias F. , Dreger Peter , Merle Uta 

TITLE=EASIX for Prediction of Outcome in Hospitalized SARS-CoV-2 Infected Patients

JOURNAL=Frontiers in Immunology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.634416

DOI=10.3389/fimmu.2021.634416

ISSN=1664-3224

ABSTRACT=Background:
The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has evoked a pandemic that challenges public health-care systems worldwide. Endothelial cell dysfunction plays a key role in pathophysiology, and simple prognosticators may help to optimize allocation of limited resources. Endothelial activation and stress index (EASIX) is a validated predictor of endothelial complications and outcome after allogeneic stem cell transplantation. Aim of this study was to test if EASIX could predict life-threatening complications in patients with COVID-19.
Methods:
SARS-CoV-2-positive, hospitalized patients were enrolled onto a prospective non-interventional register study (n=100). Biomarkers were assessed at hospital admission. Primary endpoint was severe course of disease (mechanical ventilation and/or death, V/D). Results were validated in 126 patients treated in two independent institutions.
Results:
EASIX at admission was a strong predictor of severe course of the disease (odds ratio for a two-fold change 4.2, 95%CI 1.9-9.3, p<0.001), time to V/D (hazard ratio (HR) for a two-fold change 2.2, 95%CI 1.6-3.0, p<0.001) as well as survival (HR for a two-fold change 2.1, 95%CI 1.4-3.1, p<0.001). The effect was retained in multivariable analysis adjusting for age, gender, and comorbidities and could be validated in the independent cohort. EASIX correlated with increased suppressor of tumorigenicity-2, soluble thrombomodulin, and angiopoietin-2 at admission.
Conclusion:
EASIX is a validated predictor of COVID19 outcome and an easy-to-access tool to segregate patients in need for intensive surveillance.