Сhitotriosidase activity in prediction of poor prognosis in COVID-19 hospitalized patients

Background. The identification of early predictors of poor outcomes of new coronavirus infection is necessary for optimizing patient management algorithms for hospitalized patients with COVID-19.

Aim. To study the role of chitotriosidase activity as a marker of unfavorable outcomes in COVID-19 hospitalized patients.

Materials and methods. The prospective observational single-center study included 347 patients with COVID-19 hospitalized in university clinic. In addition to the standard laboratory analysis (complete blood count, C-reactive protein, ferritin, creatinine, international normalized ratio, etc.) the blood serum chitotriosidase activity was determined at all the patients on admission. Primary endpoints were mortality from all causes and performing invasive ventilation (IV) and/or non-invasive ventilation (NIV). This study was approved by the Local Ethics Committee №12-21 (Clinical Trial Registry: NCT04752085).

Results. A total of 347 patients were enrolled in this study (average age 66 years, females 182 – 52.5%), 30 patients (8.6%) died during the hospitalization, 39 (11.2%) performed IV or NIV. Along with age more than 65 (odds ratio – OR 10.81, 95% confidence interval – CI 2.64–44.22) and Neutrophil-Lymphocyte Ratio higher than 7 (OR 15.89, 95% CI 3.09–81.65) chitotriosidase activity higher than 170 ng/hr/ml (OR 4.23, 95% CI 1.45–12.35) were independent predictors of mortality during hospitalization. Neutrophil-Lymphocyte Ratio higher than 5.6 (OR 11.22, 95% CI 2.37–53,1) and сhitotriosidase activity higher than 151 ng/hr/ml (OR 3.17, 95% CI 1.31–7.67) have been evaluated as predictors of performing IV/NIV.

Conclusion. Chitotriosidase level more than 151 nmol/h/mL could be considered as an early predictor of severity and poor prognosis in hospitalized patients with COVID-19.