The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study
Background The aim of this study was to elucidate the relationship between HA levels and clinical outcomes, including disease severity and prognosis.Methods A retrospective multicenter cohort analysis was conducted across three medical centers in China from September 2022 to February 2023. Patients...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2534849 |
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| author | Genhua Mu Yanjie Zhang Jialong Zhang Guangqing Cui Xiaochun Yuan Chun Pan Jingyuan Xu |
| author_facet | Genhua Mu Yanjie Zhang Jialong Zhang Guangqing Cui Xiaochun Yuan Chun Pan Jingyuan Xu |
| author_sort | Genhua Mu |
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| description | Background The aim of this study was to elucidate the relationship between HA levels and clinical outcomes, including disease severity and prognosis.Methods A retrospective multicenter cohort analysis was conducted across three medical centers in China from September 2022 to February 2023. Patients with positive nucleic acid for the novel coronavirus were included in the study. The primary endpoint is 28-day mortality.The severity was assessed by the ‘Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)’. Analyses assessed HA correlation with severity (Kendall), predictive value for mortality (logistic regression, ROC, Delong test), and survival differences (KM analysis using a Youden index-derived HA cutoff).Results A total of 862 patients (median age 72; 58.47% male) were included in the study, of whom 108 died. Non-survivors were older, more men, lower BMI, and more complicatinos. The overall median HA level was 121.65 ng/ml, significantly higher in non-survivors(p < 0.001). Kendall correlation analysis revealed a significant correlation between HA level and COVID-19 severity (correlation coefficient: 0.365, p < 0.001). Our preliminary analysis revealed positive correlations between HA and D-dimer and chest CT. In logistic regression models, HA was an independent predictor of 28-day mortality(p = 0.001). The AUROC for HA was 0.840 (95% CI: 0.806-0.974). The cut-off value was 141.65 ng/ml (sensitivity 61.27%, specificity 91.67%). KM survival analysis showed that patients with HA levels higher than 141.65 ng/ml had a significantly lower survival probability(p < 0.001).Conclusion HA may potentially function as a biomarker for COVID-19 and could provide a vital reference for the clinical treatment. |
| format | Article |
| id | doaj-art-5614920e895741f796981065db46eda0 |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-5614920e895741f796981065db46eda02025-08-20T03:25:08ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2534849The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort studyGenhua Mu0Yanjie Zhang1Jialong Zhang2Guangqing Cui3Xiaochun Yuan4Chun Pan5Jingyuan Xu6Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, ChinaDepartment of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, ChinaDepartment of Critical Care Medicine, Yancheng NO.1 People’s Hospital, Yancheng, Jiangsu, ChinaDepartment of Critical Care Medicine, Dongtai People’s Hospital, Yancheng, Jiangsu, ChinaDepartment of Critical Care Medicine, Dafeng People’s Hospital, Yancheng, Jiangsu, ChinaDepartment of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan People’s Hospital, Chengdu, ChinaDepartment of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, ChinaBackground The aim of this study was to elucidate the relationship between HA levels and clinical outcomes, including disease severity and prognosis.Methods A retrospective multicenter cohort analysis was conducted across three medical centers in China from September 2022 to February 2023. Patients with positive nucleic acid for the novel coronavirus were included in the study. The primary endpoint is 28-day mortality.The severity was assessed by the ‘Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)’. Analyses assessed HA correlation with severity (Kendall), predictive value for mortality (logistic regression, ROC, Delong test), and survival differences (KM analysis using a Youden index-derived HA cutoff).Results A total of 862 patients (median age 72; 58.47% male) were included in the study, of whom 108 died. Non-survivors were older, more men, lower BMI, and more complicatinos. The overall median HA level was 121.65 ng/ml, significantly higher in non-survivors(p < 0.001). Kendall correlation analysis revealed a significant correlation between HA level and COVID-19 severity (correlation coefficient: 0.365, p < 0.001). Our preliminary analysis revealed positive correlations between HA and D-dimer and chest CT. In logistic regression models, HA was an independent predictor of 28-day mortality(p = 0.001). The AUROC for HA was 0.840 (95% CI: 0.806-0.974). The cut-off value was 141.65 ng/ml (sensitivity 61.27%, specificity 91.67%). KM survival analysis showed that patients with HA levels higher than 141.65 ng/ml had a significantly lower survival probability(p < 0.001).Conclusion HA may potentially function as a biomarker for COVID-19 and could provide a vital reference for the clinical treatment.https://www.tandfonline.com/doi/10.1080/07853890.2025.2534849Hyaluronic acidCOVID-19severityprognosisbiomarker |
| spellingShingle | Genhua Mu Yanjie Zhang Jialong Zhang Guangqing Cui Xiaochun Yuan Chun Pan Jingyuan Xu The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study Annals of Medicine Hyaluronic acid COVID-19 severity prognosis biomarker |
| title | The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study |
| title_full | The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study |
| title_fullStr | The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study |
| title_full_unstemmed | The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study |
| title_short | The predictive value of hyaluronic acid for the severity and prognosis of COVID-19: a retrospective multicenter cohort study |
| title_sort | predictive value of hyaluronic acid for the severity and prognosis of covid 19 a retrospective multicenter cohort study |
| topic | Hyaluronic acid COVID-19 severity prognosis biomarker |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2534849 |
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