ABSTRACT
For matrix comparison, EDTA whole blood samples (freshly collected and stored at 2-8 °C until the testing) from ten healthy donors were spiked with synthetic bio-ADM to achieve two bio-ADM levels per donor spanning the measuring range. The analytical performance evaluation was mainly conducted using frozen and contrived plasma samples and to validate bio-ADM measurements with IB10 sphingotest SP ® sp bio-ADM SP ® sp . Keywords: acute care;bioactive adrenomedullin;critical care biomarker;endothelial function;Nexus IB10;point-of-care platform EN acute care bioactive adrenomedullin critical care biomarker endothelial function Nexus IB10 point-of-care platform e13 e16 4 11/28/22 20230101 NES 230101 To the Editor, Biologically active adrenomedullin (bio-ADM) is a peptide hormone that regulates the endothelial barrier function [[1]], [[2]], [[3]]. [Extracted from the article]
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has placed a significant burden on hospitals worldwide. Objective biomarkers for early risk stratification and clinical management are still lacking. The aim of this work was to determine whether bioactive adrenomedullin can assist in the risk stratification and clinical management of critically ill COVID-19 patients. Fifty-three patients with confirmed COVID-19 were included in this prospective observational cohort study between March and April 2020. Bioactive adrenomedullin (bio-ADM) plasma concentration was measured daily for seven days after admission. The prognostic value and clinical significance of bio-ADM plasma levels were evaluated for the severity of respiratory failure, the need for extracorporeal organ support and outcome (28-day mortality). Bio-ADM levels increased with the severity of acute respiratory distress syndrome (ARDS; p < 0.001) and were significantly elevated in invasively ventilated patients (p = 0.006) and patients in need of extracorporeal membrane oxygenation (p = 0.040) or renal replacement therapy (RRT; p < 0.001) compared to patients without these conditions. Non-survivors showed significantly higher bio-ADM levels than survivors (p = 0.010). Bio-ADM levels predicted 28-day mortality (C-index 0.72, 95% confidence interval 0.56-0.87, p < 0.001). Bio-ADM plasma levels correlate with disease severity, the need for extracorporeal organ assistance, and outcome, and highlight the promising value of bio-ADM in the early risk stratification and management of patients with COVID-19.