Elevated soluble urokinase plasminogen activator receptor (suPAR) in COVID-19 patients

Since renal injury, and various forms of venous thrombosis, are commonplace in patients with severe coronavirus disease 2019 (COVID-19), we aimed to review scientific studies which explored the concentration of suPAR in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with or without critical illness. Five studies could be included in our final pooled analysis, totalling 1077 COVID-19 patients, 197 (18.3%) with various forms of critical illness. The pooled analysis of these five studies demonstrates a positive difference of suPAR values in each study in patients with critical COVID-19 compared to those without. The WMD of suPAR values in patients with critical illness versus those without was 2.44 (95% CI, 2.17-2.72) ng/mL (heterogeneity, I2=64%), and 2.40 (95% CI, 1.72-3.08) ng/mL using the random effects model, respectively. Overall, suPAR values were found to be increased by 55% (95% CI, 35-75%) in COVID-19 patients with various forms of critical illness compared to those without. Taken together, the results of our analysis suggest that the measurement of suPAR in COVID-19 patients may represent a valuable tool for improving risk stratification accuracy, helping to predict the risk of developing severe consequences of SARS-CoV-2 infection, especially acute kidney injury, along with micro- and macro-thrombosis.