Evidence map›Paper›PMID 37603548›Full record

ArticlePLOS global public health2023

Point-of-care prognostication in moderate Covid-19: Analytical validation and prognostic accuracy of a soluble urokinase plasminogen activator receptor (suPAR) rapid test.

Arjun Chandna, Raman Mahajan, Priyanka Gautam, Lazaro Mwandigha, Sabine Dittrich, Vikash Kumar, Jennifer Osborn, Pragya Kumar, Constantinos Koshiaris, George M Varghese and 2 more

Open access · goldAbstract read
In one paragraph

Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 6 countries.

Arjun ChandnaCambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.ORCID https://orcid.org/0000-0003-1313-7922
Raman MahajanMédecins Sans Frontières, New Delhi, India.
Priyanka GautamDepartment of Infectious Diseases, Christian Medical College, Vellore, India.
Lazaro MwandighaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Sabine DittrichCentre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.
Vikash KumarMédecins Sans Frontières, New Delhi, India.ORCID https://orcid.org/0000-0003-1277-8170
Jennifer OsbornFoundation for Innovative Diagnostics, Geneva, Switzerland.
Pragya KumarDepartment of Community & Family Medicine, All India Institute of Medical Sciences, Patna, India.
Constantinos KoshiarisNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
George M VargheseDepartment of Infectious Diseases, Christian Medical College, Vellore, India.
Yoel LubellCentre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.
Sakib BurzaMédecins Sans Frontières, New Delhi, India.
Christian Medical College, Vellore · INFIND · CHUniversity of Oxford · GBAll India Institute of Medical Sciences · INAngkor Hospital for Children · KHLondon School of Hygiene & Tropical Medicine · GBMahidol University · TH

Funding

Wellcome Trust 220211
6 · The paper itself

Abstract

The soluble urokinase plasminogen activator receptor (suPAR) has been proposed as a biomarker for risk stratification of patients presenting with acute infections. However, most studies evaluating suPAR have used platform-based assays, the accuracy of which may differ from point-of-care tests capable of informing timely triage in settings without established laboratory capacity. Using samples and data collected during a prospective cohort study of 425 patients presenting with moderate Covid-19 to two hospitals in India, we evaluated the analytical performance and prognostic accuracy of a commercially-available rapid diagnostic test (RDT) for suPAR, using an enzyme-linked immunosorbent assay (ELISA) as the reference standard. Our hypothesis was that the suPAR RDT might be useful for triage of patients presenting with moderate Covid-19 irrespective of its analytical performance when compared with the reference test. Although agreement between the two tests was limited (bias = -2.46 ng/mL [95% CI = -2.65 to -2.27 ng/mL]), prognostic accuracy to predict supplemental oxygen requirement was comparable, whether suPAR was used alone (area under the receiver operating characteristic curve [AUC] of RDT = 0.73 [95% CI = 0.68 to 0.79] vs. AUC of ELISA = 0.70 [95% CI = 0.63 to 0.76]; p = 0.12) or as part of a published multivariable prediction model (AUC of RDT-based model = 0.74 [95% CI = 0.66 to 0.83] vs. AUC of ELISA-based model = 0.72 [95% CI = 0.64 to 0.81]; p = 0.78). Lack of agreement between the RDT and ELISA in our cohort warrants further investigation and highlights the importance of assessing candidate point-of-care tests to ensure management algorithms reflect the assay that will ultimately be used to inform patient care. Availability of a quantitative point-of-care test for suPAR opens the door to suPAR-guided risk stratification of patients with Covid-19 and other acute infections in settings with limited laboratory capacity.

Identifiers

PMID37603548
PMCPMC10441780
OpenAlexW4386022745

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.