Prognostic Value of Serum Cholinesterase Activity in Severe SARS-CoV-2–Infected Patients Requiring Intensive Care Unit Admission

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  • 1 Department of Intensive Care, Habib Bourguiba University Hospital, and University of Sfax, Sfax, Tunisia;
  • | 2 Biochemistry Laboratory, Habib Bourguiba Hospital, and University of Sfax, Sfax, Tunisia;
  • | 3 Laboratory of Microbiology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Sfax Tunisia

We evaluated the prognostic value of serum cholinesterase (SChE) levels in SARS-CoV-2–infected patients requiring intensive care unit (ICU) admission. This is a retrospective study of severe, critically ill, adult COVID-19 patients, all of whom had a confirmed SARS-CoV-2 infection and were admitted into the ICU of a university hospital. We included all patients admitted to our ICU and whose SChE levels were explored on ICU admission and during ICU stay. One hundred and thirty-seven patients were included. There were 100 male and 37 female patients. The mean of SChE activity on ICU admission was 5,656 ± 1,818 UI/L (range: 1926–11,192 IU/L). The SChE activity on ICU admission was significantly lower in nonsurvivors (P < 0.001). A significant association between the SChE activity on ICU admission and the need for invasive mechanical ventilation was found. We also found a significant correlation between the SChE activity and other biomarkers of sepsis (C-reactive protein, procalcitonin, and leukocytes) on ICU admission and during the ICU stay. A significant correlation among SChE nadir value activity recorded during ICU stay, the occurrence of nosocomial infection, and the outcome of studied patients was found. Our study shows that the low SChE activity value is associated with a severe outcome. It might be used as a biomarker to aid in prognostic risk stratification in SARS-CoV-2–infected patients. Further studies for external validation of our findings are needed on this subject.

Author Notes

Address correspondence to Mabrouk Bahloul, Department of Intensive Care, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia. E-mail: bahloulmab@yahoo.fr

Authors’ addresses: Mabrouk Bahloul, Sana Kharrat, Saba Makni, Najeh Baccouche, Rania Ammar, Olfa Turki, Chokri Ben Hamida, Hedi Chelly, Kamilia Chtara, Fatma Ayedi, and Mounir Bouaziz, Department of Intensive Care, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia, E-mails: bahloulmab@yayoo.fr, sanakharrat15@hotmail.com, saba.makni@rns.tn, baccouch.najeh@gmail.com, rania.ammarzayani@gmail.com, olfa.turki.rea@gmail.com, chokri_benhamida@yahoo.fr, hedi.chelly@rns.tn, kamilia.chtaraelaoud@gmail.com, fatma.ayedi@rns.tn, and mounir.bouaziz@rns.tn. Aida Eleuch, Biochemistry Laboratory, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia, E-mail: aida.eleuch@rns.tn. Lamia Berrajah and Amel Chtourou, Laboratory of Microbiology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia, E-mails: lamia.berrajah@rns.tn and amel.chtourou@rns.tn. Fatma Ayedi, Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia, E-mail: XXXXX.

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