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

Giuseppe Lippi, Brandon M. Henry, Emmanuel J. Favaloro

Research output: Contribution to journalLetterpeer-review

1 Citation (Scopus)


To the Editor,
Soluble urokinase-type plasminogen activator receptor (suPAR) is a soluble receptor derived from enzymatic cleavage of the membrane uPAR receptor at the surface of blood mononuclear and endothelial cells in response to a vast array of inflammatory and immunomodulatory stimuli, including viral infections [1]. Beside its consolidated role as a bioactive factor associated with various forms of endothelial dysfunction and sepsis [1], plasma levels of suPAR can predict the risk of developing both acute and chronic renal injury and failure [2, 3]. Recent evidence also suggests that this biomarker may have a role in a variety of thrombotic diseases. In a large population-based cohort study conducted by Engström et al. [4], including over 5,000 participants of the Malmö Diet and Cancer (MDC) study, high levels of suPAR were found to independently predict the risk of developing venous thromboembolism (hazard ratio, 1.7; 95% confidence interval [95% CI], 1.1–2.5 in the fully-adjusted model). In another study, not only were suPAR values found to be higher in patients with paroxysmal nocturnal hemoglobinuria (PNH) compared to healthy controls, but levels were also associated with the risk of developing thrombotic events, and thrombosis-free survival was shorter in patients with suPAR values ≥2 ng/mL [5]. Since renal injury [6], and various forms of venous thrombosis [7, 8], 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.
Original languageEnglish
Pages (from-to)E413-E415
Number of pages3
JournalClinical Chemistry and Laboratory Medicine
Issue number11
Early online date14 Jun 2021
Publication statusPublished - Oct 2021


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