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Placental growth factor level in plasma predicts COVID‐19 severity and in‐hospital mortality
Author(s) -
Smadja David M.,
Philippe Aurélien,
Bory Olivier,
Gendron Nicolas,
Beauvais Agathe,
Gruest Maxime,
Peron Nicolas,
Khider Lina,
Guerin Coralie L.,
Goudot Guillaume,
Levavasseur Françoise,
Duchemin Jérome,
Pene Frédéric,
Cheurfa Cherifa,
Szwebel TaliAnne,
Sourdeau Elise,
Planquette Benjamin,
HauwBerlemont Caroline,
Hermann Bertrand,
Gaussem Pascale,
Samama CharlesMarc,
Mirault Tristan,
Terrier Benjamin,
Sanchez Olivier,
Rance Bastien,
Fontenay Michaela,
Diehl JeanLuc,
Chocron Richard
Publication year - 2021
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.15339
Subject(s) - medicine , placental growth factor , hazard ratio , odds ratio , confidence interval , proportional hazards model , gastroenterology , receiver operating characteristic , area under the curve , risk factor , vascular endothelial growth factor , vegf receptors
Background Coronavirus disease 2019 (COVID‐19) is a respiratory disease associated with vascular inflammation and endothelial injury. Objectives To correlate circulating angiogenic markers vascular endothelial growth factor A (VEGF‐A), placental growth factor (PlGF), and fibroblast growth factor 2 (FGF‐2) to in‐hospital mortality in COVID‐19 adult patients. Methods Consecutive ambulatory and hospitalized patients with COVID‐19 infection were enrolled. VEGF‐A, PlGF, and FGF‐2 were measured in each patient ≤48 h following admission. Results The study enrolled 237 patients with suspected COVID‐19: 208 patients had a positive diagnostic for COVID‐19, of whom 23 were mild outpatients and 185 patients hospitalized after admission. Levels of VEGF‐A, PlGF, and FGF‐2 significantly increase with the severity of the disease ( P < .001). Using a logistic regression model, we found a significant association between the increase of FGF‐2 or PlGF and mortality (odds ratio [OR] 1.11, 95% confidence interval [CI; 1.07–1.16], P < .001 for FGF‐2 and OR 1.07 95% CI [1.04–1.10], P < .001 for PlGF) while no association were found for VEGF‐A levels. Receiver operating characteristic curve analysis was performed and we identified PlGF above 30 pg/ml as the best predictor of in‐hospital mortality in COVID‐19 patients. Survival analysis for PlGF confirmed its interest for in‐hospital mortality prediction, by using a Kaplan‐Meier survival curve ( P = .001) and a Cox proportional hazard model adjusted to age, body mass index, D‐dimer, and C‐reactive protein (3.23 95% CI [1.29–8.11], P = .001). Conclusion Angiogenic factor PlGF is a relevant predictive factor for in‐hospital mortality in COVID‐19 patients. More than a biomarker, we hypothesize that PlGF blocking strategies could be a new interesting therapeutic approach in COVID‐19.