Introduction: The workload of physicians increased due to the number of patients presenting with suspicion of coronavirus 2019 (COVID-19) and the prolonged wait times in the emergency department during the COVID-19 pandemic. Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) is a protein present in platelets and endothelial cells; it is activated by inflammation from COVID-19 and may be associated with COVID-19’s known thrombotic risk. We aimed to determine whether SCUBE-1 levels are diagnostically correlated in suspected COVID-19 patients, and whether SCUBE-1 correlated with severity of disease and, therefore, might be useful to guide hospitalization/discharge decisions.
\nMethods: The suspected COVID-19 patients cared for at tertiary healthcare institutions for one year between May 2021–May 2022 were examined in this study. The subjects were both suspected COVID-19 patients not ultimately found to have COVID-19 and those who were diagnosed with COVID-19. By modifying the disease severity scoring systems present in COVID-19 guidelines in 2021, the COVID-19-positive patient group was classified as mild, moderate, severe, and critical, and compared using the SCUBE-1 levels. Moreover, SCUBE-1 levels were compared between the COVID-19 positive group and the COVID-19 negative group.
\nResults: A total of 507 patients were considered for the present study. After excluding 175 patients for incomplete data and alternate comorbid organ failure. we report on 332 patients (65.5%). Of these 332 patients, 80 (24.0%) were COVID-19 negative, and 252 (76.0%) were COVID-19 positive. Of 252 (100%) patients diagnosed with COVID-19, 74 (29.4%) were classified as mild, 95 (37.7%) moderate, 45 (17.8%) severe, and 38 (15.1%) critical. The SCUBE-1 levels were statistically different between COVID-19 positive (8.48 ± 7.42 nanograms per milliliter [ng/mL]) and COVID-19 negative (1.86 ± 0.92 ng/mL) patients (P < 0.001). In the COVID-19 positive group, SCUBE-1 levels increased with disease severity (mild = 3.20 ± 1.65 ng/mL, moderate = 4.78 ± 2.26 ng/mL, severe = 13.68 ± 3.95 ng/mL, and critical = 21.87 ± 5.39 ng/mL) (P < 0.001). The initial SCUBE-1 levels of discharged patients were significantly lower than those requiring hospitalization (discharged = 2.89 ng/mL [0.55–8.60 ng/mL]; ward admitted = 7.13 ng/mL [1.38–21.29 ng/mL], and ICU admitted = 21.19 ng/mL [10.58–37.86 ng/mL]) (P < 0.001).
\nConclusion: The SCUBE-1 levels were found to be differentiated between patients with and without COVID-19 and to be correlated with the severity of illness.
","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Departments"},{"word":"COVID 19"},{"word":"SCUBE-1"},{"word":"Diagnosis"},{"word":"Hospitalization"},{"word":"patient discharge"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2z7033t5","frozenauthors":[{"first_name":"Vildan","middle_name":"","last_name":"Ozer","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Emergency Medicine, Trabzon, Türkiye","department":""},{"first_name":"Ozgen","middle_name":"","last_name":"Gonenc Cekic","name_suffix":"","institution":"SBU Kanuni Training and Research Hospital, Department of Emergency Medicine, Trabzon, Türkiye","department":"None"},{"first_name":"Ozlem","middle_name":"","last_name":"Bulbul","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Emergency Medicine, Trabzon, Türkiye","department":"None"},{"first_name":"Davut","middle_name":"","last_name":"Aydın","name_suffix":"","institution":"SBU Kanuni Training and Research Hospital, Department of Chest Diseases, Division of Intensive Care Medicine, Trabzon, Türkiye","department":"None"},{"first_name":"Eser","middle_name":"","last_name":"Bulut","name_suffix":"","institution":"SBU Kanuni Training and Research Hospital, Department of Radiology, Trabzon, Türkiye","department":"None"},{"first_name":"Firdevs","middle_name":"","last_name":"Aksoy","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Türkiye","department":"None"},{"first_name":"Mehtap","middle_name":"","last_name":"Pehlivanlar Kucuk","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Chest Diseases, Division of Intensive Care Medicine, Trabzon, Türkiye","department":"None"},{"first_name":"Suleyman","middle_name":"Caner","last_name":"Karahan","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Biochemistry, Trabzon, Türkiye","department":"None"},{"first_name":"Ebru","middle_name":"Emel","last_name":"Sozen","name_suffix":"","institution":"SBU Kanuni Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Türkiye","department":"None"},{"first_name":"Esra","middle_name":"","last_name":"Ozkaya","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Medical Microbiology, Trabzon, Türkiye","department":"None"},{"first_name":"Polat","middle_name":"","last_name":"Kosucu","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Radiology, Trabzon, Türkiye","department":"None"},{"first_name":"Yunus","middle_name":"","last_name":"Karaca","name_suffix":"","institution":"Karadeniz Technical University, School of Medicine, Department of Emergency Medicine, Trabzon, Türkiye","department":"None"},{"first_name":"Suleyman","middle_name":"","last_name":"Turedi","name_suffix":"","institution":"SBU Kanuni Training and Research Hospital, Department of Emergency Medicine, Trabzon, Türkiye","department":"None"}],"date_submitted":"2023-11-17T11:58:36-08:00","date_accepted":"2024-08-12T12:27:25.062000-07:00","date_published":"2024-10-02T06:00:00-07:00","render_galley":{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18586/galley/26548/download/"},"galleys":[{"label":"Layout","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18586/galley/26419/download/"},{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18586/galley/26548/download/"}]}