# Evaluation of suPAR as a Key Prognostic Biomarker in Patients with SARS-CoV-2 Pneumonia

## TL;DR

This study shows that the suPAR biomarker can better predict severe outcomes in patients with SARS-CoV-2 pneumonia compared to existing tools.

## Contribution

The study demonstrates that combining suPAR with the CURB-65 score improves risk stratification for patients with SARS-CoV-2 pneumonia.

## Key findings

- suPAR outperformed lymphocyte count and CURB-65 in predicting ICU admission.
- No patient with suPAR < 4 ng/mL experienced severe outcomes.
- Combining suPAR with CURB-65 significantly improved risk classification.

## Abstract

Background/Objectives: SARS-CoV-2 has strained healthcare systems, emphasizing the need for biomarkers to predict disease severity. Recent studies suggest that soluble urokinase plasminogen activator receptor (suPAR) is a promising marker for COVID-19 pneumonia, though its utility alongside the CURB-65 score remains unstudied. This study evaluates the prognostic value of suPAR in comparison to leukocyte count and CURB-65, and its potential for enhancing risk stratification in a combined CURB-65 model. Methods: Biomarkers and CURB-65 scores were obtained for 240 immunocompetent patients hospitalised with COVID-19 pneumonia. Intensive care unit admission and in-hospital mortality were assessed using receiver operating characteristic (ROC) curves and Kaplan–Meier analysis. Additionally, a Net Reclassification Improvement (NRI) analysis was performed to evaluate the predictive value of suPAR combined with the CURB-65 score for risk stratification. Results: suPAR demonstrated strong diagnostic accuracy, outperforming lymphocyte count and showing greater precision than the CURB-65 score for ICU admission. Notably, no patient with suPAR < 4 ng/mL experienced the studied outcomes. NRI analysis revealed a significant improvement in risk classification when suPAR was combined with CURB-65. Conclusions: The addition of the suPAR biomarker to the CURB-65 score represents a substantial improvement in the risk classification of patients with COVID-19 pneumonia, with a potential impact on daily clinical practice.