Exploratory characterization of dynamic soluble programmed death-ligand 1 trajectories and their association with mortality in critical coronavirus disease 2019
Authors' conclusion
Sustained sPD-L1 elevation during the first ICU week is strongly associated with early organ dysfunction and independently predicts death in critical COVID-19.
Study context
- Population
- Adults with severe COVID-19 pneumonia admitted to the intensive care unit (ICU) (April 2021-December 2022)plus 23 healthy controls
- Participants
- 40 adults
- Exposure
- Non-survivors vs survivors
- Non-survivorsn = 10
- Healthy volunteersn = 23
- Outcome
- Hospital mortality
Methodological detailssingle-centre, exploratory, machine learning
- Single-centre
- Exploratory
- Machine learning
Main finding
As reported in the abstract
Hospital mortality and sPD-L1
Non-survivors
10
events
Non-survivors vs Survivors: P = 0.023 · Non-survivors vs Survivors: 0.001
Observational data: associations, not effects.
Further findings
Correlation of ICU day 7 sPD-L1 with organ dysfunction markers
- Positive correlation with creatinine, C-reactive protein and fibrinogen
- all p < 0.05
- Cross-sectional correlation analyses
Machine learning (ML) discrimination of mortality
- Support vector machine, highest discriminative accuracy (mean AUC)
- 0.917
- ICU day 5 sPD-L1 primary predictor by SHAP; lactate contributed minimally
- Stratified fivefold cross-validation
Original publication
Exploratory characterization of dynamic soluble programmed death-ligand 1 trajectories and their association with mortality in critical coronavirus disease 2019. J Intensive Care. Published 5 January 2026. doi:10.
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