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Article: Neopterin Predicts Disease Severity in Hospitalized Patients With COVID-19.

Bellmann-Weiler, Rosa / Lanser, Lukas / Burkert, Francesco / Seiwald, Stefanie / Fritsche, Gernot / Wildner, Sophie / Schroll, Andrea / Koppelstätter, Sabine / Kurz, Katharina / Griesmacher, Andrea / Weiss, Günter

Open forum infectious diseases

2020 Volume 8, Issue 1, Page(s) ofaa521

Abstract: ... Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical ... COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease ... in patients with coronavirus disease 2019 (COVID-19). Within this retrospective analysis of 115 hospitalized ...

Abstract	This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with coronavirus disease 2019 (COVID-19). Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for intensive care unit admission, need for mechanical ventilation, and death. Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients.
Language	English
Publishing date	2020-11-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofaa521
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Neopterin predicts disease severity in hospitalized patients with COVID-19

Bellmann-Weiler, Rosa Lanser Lukas Burkert Francesco Seiwald Stefanie Fritsche Gernot Wildner Sophie Schroll Andrea Koppelstätter Sabine Kurz Katharina Griesmacher Andrea Weiss Günter

Open Forum Infectious Diseases

Abstract: ... in patients with COVID-19 Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated ... in patients with COVID-19 and may help to improve the clinical management of patients ... neopterin levels upon admission were significantly associated with disease severity, risk for ICU admission ...

Abstract	This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with COVID-19 Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for ICU admission, need for mechanical ventilation and death Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #900464
Database	COVID19

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Article ; Online: Neopterin predicts disease severity in hospitalized patients with COVID-19

Open Forum Infectious Diseases ; ISSN 2328-8957

2020

Abstract: ... neopterin, in patients with COVID-19. Within this retrospective analysis of 115 hospitalized COVID-19 ... patients, elevated neopterin levels upon admission were significantly associated with disease severity ... predictive marker in patients with COVID-19 and may help to improve the clinical management of patients. ...

Abstract	Abstract This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with COVID-19. Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for ICU admission, need for mechanical ventilation and death. Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients.
Keywords	Oncology ; Clinical Neurology ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
DOI	10.1093/ofid/ofaa521
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The novel biomarker, neopterin, can predict the severity of COVID-19.

Karacaer, C / Yaylaci, S / Issever, K / Sert, H / Suner, K O / Cokluk, E / Nalbant, A / Demirci, T / Varim, C / Kaya, T

European review for medical and pharmacological sciences

2022 Volume 26, Issue 15, Page(s) 5568–5573

Abstract: ... intensive care (Moderate COVID-19; M-COVID-19). Patients' clinical characteristics, serum neopterin levels, and ... This retrospective study included 87 hospitalized patients who were diagnosed with COVID-19. Patients were divided into two ... mortality in COVID-19 patients.: Conclusions: Although we did not find statistically significant results ...

Abstract	Objective: SARS-CoV-2 infection primarily affects T-lymphocytes, particularly CD4+ and CD8+ T cells. However, there is a need for simpler and less expensive laboratory tests with predictive values comparable to CD4+ cell counts. Thus, the goal of this study was to investigate the role of neopterin levels in predicting intensive care and mortality in coronavirus disease patients in 2019. Patients and methods: This retrospective study included 87 hospitalized patients who were diagnosed with COVID-19. Patients were divided into two groups: those receiving intensive care (Severe COVID-19; S-COVID-19) and those receiving non-intensive care (Moderate COVID-19; M-COVID-19). Patients' clinical characteristics, serum neopterin levels, and other laboratory data were compared across groups. Results: The average age was 63.9±155.2 years, and 44 (%) of the participants were male. WBC (p = 0.008), neutrophil (p = 0.002), HDL (p = 0.009), ferritin, calcium, albumin, LDH, APTT, lymphocyte, INR, D-dimer, troponin, prothrombin time sedimentation, and PaO2 (p = 0.001) were all associated with death. The neopterin level in the M-COVID-19 group was 3 (min-max; 3.1-5.9) and 3.2 (2.3-7) in the S-COVID-19 group, with no statistically significant difference (p = 0.456). Gender differences between groups were not significant (p = 0.183). According to the ROC analysis, if parameters such as age, D-Dimer, troponin, ferritin, albumin, LDH, CRP, procalcitonin, and PaO2 exceed the cut-off values and lymphocyte levels are below, it can predict the need for intensive care and mortality in COVID-19 patients. Conclusions: Although we did not find statistically significant results with neopterin in terms of mortality in COVID-19 individuals in our study, more thorough, prospective, randomized controlled studies with expanded patient populations at various phases of the disease are needed.
MeSH term(s)	Albumins ; Biomarkers ; COVID-19/diagnosis ; Female ; Ferritins ; Humans ; Male ; Neopterin ; Oxygen ; Prospective Studies ; Retrospective Studies ; SARS-CoV-2 ; Troponin
Chemical Substances	Albumins ; Biomarkers ; Troponin ; Neopterin (670-65-5) ; Ferritins (9007-73-2) ; Oxygen (S88TT14065)
Language	English
Publishing date	2022-08-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
DOI	10.26355/eurrev_202208_29428
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Article ; Online: Inflammatory markers and neopterin levels in relation to mild COVID-19.

Karabulut, A / Şahin, M

European review for medical and pharmacological sciences

2023 Volume 27, Issue 18, Page(s) 8952–8961

Abstract: ... The present study found that neopterin levels were not elevated in mild/moderate COVID-19 patients. ... show statistically significant differences in serum neopterin levels between the mild/moderate COVID-19 ... values exceeding the cutoff values may be predictive of COVID-19.: Conclusions: Although there were no ...

Abstract	Objective: The immunopathology of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection involves an excessive inflammatory response. Approximately 80% of patients with coronavirus disease 2019 (COVID-19) have a mild illness, 20% require hospitalization, and approximately 5% require intensive care. Neopterin is a macrophage activation marker produced by monocytes and macrophages following activation by interferon-gamma (IFN-γ). It is crucial to determine neopterin levels and evaluate them together with inflammatory, coagulation, and biochemical markers in moderate/mild SARS-CoV-2 infection. Patients and methods: The present study compared plasma neopterin and inflammatory as well as biochemical markers of 50 patients with COVID-19 and 38 healthy volunteers without COVID-19. Results: The data of 38 participants did not show statistically significant differences in serum neopterin levels between the mild/moderate COVID-19 and control groups (p=0.259). White blood cell (WBC), neutrophil, lymphocyte, platelet (PLT), hemoglobin (HGB), procalcitonin (PCT), ferritin, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR) and lymphocyte CRP ratio (LCR) values were significantly different between the study groups (p<0.001, p=0.001, p=0.001, p<0.001, p=0.014, p<0.001, p=0.001, p<0.001, p=0.004, p<0.001, p<0.001, respectively). According to the ROC analysis, the WBC, PT, Na, and LCR values exceeding the cutoff values may be predictive of COVID-19. Conclusions: Although there were no significant differences in serum neopterin levels between the groups, there were high values in patients with severe SARS-CoV-2 infection in previous studies and these values were maintained for a long time. The present study found that neopterin levels were not elevated in mild/moderate COVID-19 patients.
MeSH term(s)	Humans ; COVID-19 ; Neopterin ; SARS-CoV-2 ; Blood Coagulation Tests ; Biomarkers
Chemical Substances	Neopterin (670-65-5) ; Biomarkers
Language	English
Publishing date	2023-10-23
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
DOI	10.26355/eurrev_202309_33816
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Article ; Online: The prognostic role of neopterin in COVID-19 patients.

Ozger, Hasan Selcuk / Dizbay, Murat / Corbacioglu, Seref Kerem / Aysert, Pinar / Demirbas, Zehra / Tunccan, Ozlem Guzel / Hizel, Kenan / Bozdayi, Gulendam / Caglar, Kayhan

Journal of medical virology

2020 Volume 93, Issue 3, Page(s) 1520–1525

Abstract: ... of the disease. High levels of circulating cytokines were reported in severe COVID-19 patients. Neopterin ... COVID-19 disease than mild COVID-19 patients. Neopterin levels can be used as an early prognostic ... disease in patients with COVID-19. This single-center, prospective study was conducted in hospitalized ...

Abstract	In Coronavirus disease-2019 (COVID-19) cases, hyper inflammation is associated with the severity of the disease. High levels of circulating cytokines were reported in severe COVID-19 patients. Neopterin produced by macrophages on stimulation with interferon-gamma, which is an important cytokine in the antiviral immune response, hence it can be used to predict the severity of disease in COVID-19 cases. In this study, it was aimed to determine the prognostic value of the neopterin for the prediction of severe disease in patients with COVID-19. This single-center, prospective study was conducted in hospitalized COVID-19 patients and healthy volunteers. Severe and mild COVID-19 cases were compared in terms of clinical and laboratory findings as well as serum neopterin levels on hospital admission. To assess the prognostic utility of neopterin between the severe and mild COVID-19 groups, a receiver-operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated. The median serum neopterin level was four times higher in COVID-19 patients than the healthy controls (46 vs. 12 nmol/L; p < .001). The AUC value of serum neopterin was 0.914 (95% confidence interval, 0.85-0.97). The sensitivity and specificity of serum neopterin for the cut-off value of 90 nmol/L to identify severe COVID-19 cases were 100% and 76%, respectively. Serum neopterin levels on hospitalization were significantly higher in severe COVID-19 disease than mild COVID-19 patients. Neopterin levels can be used as an early prognostic biomarker for COVID-19 on admission.
MeSH term(s)	Adult ; Biomarkers/blood ; Bronchoalveolar Lavage Fluid/cytology ; COVID-19/diagnosis ; COVID-19/mortality ; COVID-19/pathology ; Cytokines/blood ; Female ; Humans ; Interferon-gamma/immunology ; Macrophages/immunology ; Male ; Middle Aged ; Neopterin/blood ; Prognosis ; SARS-CoV-2/immunology ; Severity of Illness Index ; Young Adult
Chemical Substances	Biomarkers ; Cytokines ; IFNG protein, human ; Neopterin (670-65-5) ; Interferon-gamma (82115-62-6)
Keywords	covid19
Language	English
Publishing date	2020-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.26472
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Article ; Online: Neopterin and kynurenine in serum and urine as prognostic biomarkers in hospitalized patients with delta and omicron variant SARS-CoV-2 infection.

Krčmová, Lenka Kujovská / Matoušová, Kateřina / Javorská, Lenka / Šmahel, Petr / Skála, Mikuláš / Koblížek, Vladimír / Škop, Jan / Turoňová, Dorota / Gančarčíková, Markéta / Melichar, Bohuslav

Clinical chemistry and laboratory medicine

2023 Volume 61, Issue 11, Page(s) 2053–2064

Abstract: ... of progression to a severe coronavirus disease (COVID)-19. Even in patients with known risk factors ... 19 patients hospitalized at the University Hospital Hradec Králové, Czech Republic. Delta and omicron ... or in the urine represent promising biomarkers in the management of COVID-19 that may help to guide ...

Abstract	Objectives: Currently, no biomarker or scoring system could clearly identify patients at risk of progression to a severe coronavirus disease (COVID)-19. Even in patients with known risk factors, the fulminant course cannot be predicted with certainty. Analysis of commonly determined clinical parameters (frailty score, age, or body mass index) together with routine biomarkers of host response (C-reactive protein and viral nucleocapsid protein) in combination with new biomarkers neopterin, kynurenine, and tryptophan, could aid in predicting the patient outcome. Methods: In 2021 and 2022, urine and serum samples were prospectively collected on 1st to 4th day after hospital admission in 108 consecutive COVID-19 patients hospitalized at the University Hospital Hradec Králové, Czech Republic. Delta and omicron virus variants were studied. Neopterin, kynurenine and tryptophan were determined by liquid chromatography. Results: A significant correlation was observed between urinary and serum biomarker concentrations. Urinary and serum neopterin, kynurenine and kynurenine/tryptophan ratio were significantly (p≤0.05) higher in patients who subsequently needed oxygen therapy vs. patients without oxygen therapy. These parameters were also significantly increased in patients who died during the hospitalization compared to survivors. Complex equations have been derived using the investigated biomarkers and other clinical or laboratory parameters to predict the risk of subsequent oxygen therapy or death during hospitalization. Conclusions: Present data demonstrate that neopterin, kynurenine and kynurenine/tryptophan ratio in the serum or in the urine represent promising biomarkers in the management of COVID-19 that may help to guide important therapeutic decisions.
MeSH term(s)	Humans ; Kynurenine ; Tryptophan ; Neopterin ; Prognosis ; COVID-19/diagnosis ; SARS-CoV-2 ; Biomarkers ; Oxygen
Chemical Substances	Kynurenine (343-65-7) ; Tryptophan (8DUH1N11BX) ; Neopterin (670-65-5) ; Biomarkers ; Oxygen (S88TT14065)
Language	English
Publishing date	2023-06-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2023-0381
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Article: The prognostic role of neopterin in COVID-19 patients

Ozger, Hasan Selcuk / Dizbay, Murat / Corbacioglu, Seref Kerem / Aysert, Pinar / Demirbas, Zehra / Tunccan, Ozlem Guzel / Hizel, Kenan / Bozdayi, Gulendam / Caglar, Kayhan

J. med. virol

Abstract	In Coronavirus disease-2019 (COVID-19) cases, hyper inflammation is associated with the severity of the disease. High levels of circulating cytokines were reported in severe COVID-19 patients. Neopterin produced by macrophages on stimulation with interferon-gamma, which is an important cytokine in the antiviral immune response, hence it can be used to predict the severity of disease in COVID-19 cases. In this study, it was aimed to determine the prognostic value of the neopterin for the prediction of severe disease in patients with COVID-19. This single-center, prospective study was conducted in hospitalized COVID-19 patients and healthy volunteers. Severe and mild COVID-19 cases were compared in terms of clinical and laboratory findings as well as serum neopterin levels on hospital admission. To assess the prognostic utility of neopterin between the severe and mild COVID-19 groups, a receiver-operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated. The median serum neopterin level was four times higher in COVID-19 patients than the healthy controls (46 vs. 12 nmol/L; p < .001). The AUC value of serum neopterin was 0.914 (95% confidence interval, 0.85-0.97). The sensitivity and specificity of serum neopterin for the cut-off value of 90 nmol/L to identify severe COVID-19 cases were 100% and 76%, respectively. Serum neopterin levels on hospitalization were significantly higher in severe COVID-19 disease than mild COVID-19 patients. Neopterin levels can be used as an early prognostic biomarker for COVID-19 on admission.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #734155
Database	COVID19

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Article ; Online: Elevated Neopterin Levels Predict Fatal Outcome in SARS-CoV-2-Infected Patients.

Frontiers in cellular and infection microbiology

2021 Volume 11, Page(s) 709893

Abstract: ... that neopterin may serve as a biomarker of SARS-CoV-2 viral infection and Covid-19 disease severity.: Methods ... 374 Covid-19 patients at hospital admission. Enrolled Covid-19 patients were all symptomatic and ... above 19nM stratified healthy individuals from Covid-19 patients with 87% specificity and 100 ...

Abstract	Highlights: Innate immune activation during Covid-19 infection is associated with pernicious clinical outcome. Background: Coronavirus disease 2019 (Covid-19) is a worldwide threat that has already caused more than 3 000 000 deaths. It is characterized by different patterns of disease evolution depending on host factors among which old-age and pre-existing comorbidities play a detrimental role. Previous coronavirus epidemics, notably SARS-CoV, were associated with increased serum neopterin levels, which can be interpreted as a sign of acute innate immunity in response to viral infection. Here we hypothesize that neopterin may serve as a biomarker of SARS-CoV-2 viral infection and Covid-19 disease severity. Methods: We measured neopterin blood levels by ELISA. Seric concentration was quantified from 256 healthy donors and 374 Covid-19 patients at hospital admission. Enrolled Covid-19 patients were all symptomatic and displayed a large spectrum of comorbidities. Patients were followed until disease resolution or death. Results: Severe and critically ill SARS-CoV-2 infected patients were characterized by a profound exacerbation of immune activation characterized by elevated neopterin blood levels. Systemic neopterin levels above 19nM stratified healthy individuals from Covid-19 patients with 87% specificity and 100% sensitivity. Moreover, systemic neopterin levels above 53nM differentiated non-survivors from survivors with 64% specificity and 100% sensitivity. Conclusion: We propose that neopterin concentration measured at arrival to hospital is a hallmark of severe Covid-19 and identifies a high-risk population of pernicious clinical outcome with a need for special medical care.
MeSH term(s)	COVID-19 ; Critical Illness ; Humans ; Neopterin
Chemical Substances	Neopterin (670-65-5)
Language	English
Publishing date	2021-08-23
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2021.709893
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