Prospective validation study of prognostic biomarkers to predict adverse outcomes in patients with COVID-19: a study protocol

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Author(s)
Tang, Benjamin
Shojaei, Maryam
Wang, Ya
Nalos, Marek
Mclean, Anthony
Afrasiabi, Ali
Kwan, Tim N
Kuan, Win Sen
Zerbib, Yoann
Herwanto, Velma
Gunawan, Gunawan
Cox, Amanda J
West, Nicholas P
Cripps, Allan William
et al.
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2021
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Abstract

INTRODUCTION: Accurate triage is an important first step to effectively manage the clinical treatment of severe cases in a pandemic outbreak. In the current COVID-19 global pandemic, there is a lack of reliable clinical tools to assist clinicians to perform accurate triage. Host response biomarkers have recently shown promise in risk stratification of disease progression; however, the role of these biomarkers in predicting disease progression in patients with COVID-19 is unknown. Here, we present a protocol outlining a prospective validation study to evaluate the biomarkers' performance in predicting clinical outcomes of patients with COVID-19. METHODS AND ANALYSIS: This prospective validation study assesses patients infected with COVID-19, in whom blood samples are prospectively collected. Recruited patients include a range of infection severity from asymptomatic to critically ill patients, recruited from the community, outpatient clinics, emergency departments and hospitals. Study samples consist of peripheral blood samples collected into RNA-preserving (PAXgene/Tempus) tubes on patient presentation or immediately on study enrolment. Real-time PCR (RT-PCR) will be performed on total RNA extracted from collected blood samples using primers specific to host response gene expression biomarkers that have been previously identified in studies of respiratory viral infections. The RT-PCR data will be analysed to assess the diagnostic performance of individual biomarkers in predicting COVID-19-related outcomes, such as viral pneumonia, acute respiratory distress syndrome or bacterial pneumonia. Biomarker performance will be evaluated using sensitivity, specificity, positive and negative predictive values, likelihood ratios and area under the receiver operating characteristic curve. ETHICS AND DISSEMINATION: This research protocol aims to study the host response gene expression biomarkers in severe respiratory viral infections with a pandemic potential (COVID-19). It has been approved by the local ethics committee with approval number 2020/ETH00886. The results of this project will be disseminated in international peer-reviewed scientific journals.

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BMJ Open

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11

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1

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© Author(s) (or their employer(s)) 2021. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Clinical sciences

Health services and systems

Public health

Other health sciences

Biomedical and clinical sciences

Health sciences

Psychology

COVID-19

adult intensive & critical care

immunology

molecular diagnostics

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Tang, B; Shojaei, M; Wang, Y; Nalos, M; Mclean, A; Afrasiabi, A; Kwan, TN; Kuan, WS; Zerbib, Y; Herwanto, V; Gunawan, G; Cox, AJ; West, NP; Cripps, AW; et al., PREDICT-19 consortium, Prospective validation study of prognostic biomarkers to predict adverse outcomes in patients with COVID-19: a study protocol, BMJ Open, 2021, 11 (1), pp. e044497

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