MR-proADM as marker of endotheliitis predicts COVID-19 severity.
Eur J Clin Invest
; 51(5): e13511, 2021 May.
Article
in English
| MEDLINE | ID: covidwho-1078956
ABSTRACT
BACKGROUND:
Early identification of patients at high risk of progression to severe COVID-19 constituted an unsolved challenge. Although growing evidence demonstrates a direct association between endotheliitis and severe COVID-19, the role of endothelial damage biomarkers has been scarcely studied. We investigated the relationship between circulating mid-regional proadrenomedullin (MR-proADM) levels, a biomarker of endothelial dysfunction, and prognosis of SARS-CoV-2-infected patients.METHODS:
Prospective observational study enrolling adult patients with confirmed COVID-19. On admission to emergency department, a blood sample was drawn for laboratory test analysis. Primary and secondary endpoints were 28-day all-cause mortality and severe COVID-19 progression. Area under the curve (AUC) and multivariate regression analysis were employed to assess the association of the biomarker with the established endpoints.RESULTS:
A total of 99 patients were enrolled. During hospitalization, 25 (25.3%) cases progressed to severe disease and the 28-day mortality rate was of 14.1%. MR-proADM showed the highest AUC to predict 28-day mortality (0.905; [CI] 95% 0.829-0.955; P < .001) and progression to severe disease (0.829; [CI] 95% 0.740-0.897; P < .001), respectively. MR-proADM plasma levels above optimal cut-off (1.01 nmol/L) showed the strongest independent association with 28-day mortality risk (hazard ratio [HR] 10.470, 95% CI 2.066-53.049; P < .005) and with progression to severe disease (HR 6.803, 95% CI 1.458-31.750; P = .015).CONCLUSION:
Mid-regional proadrenomedullin was the biomarker with highest performance for prognosis of death and progression to severe disease in COVID-19 patients and represents a promising predictor for both outcomes, which might constitute a potential tool in the assessment of prognosis in early stages of this disease.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Peptide Fragments
/
Protein Precursors
/
Endothelium, Vascular
/
Mortality
/
Adrenomedullin
/
COVID-19
/
Inflammation
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Eur J Clin Invest
Year:
2021
Document Type:
Article
Affiliation country:
Eci.13511
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