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Mid-regional pro-atrial natriuretic peptide independently predicts short-term mortality in COVID-19.
Kaufmann, Christoph C; Ahmed, Amro; Kassem, Mona; Freynhofer, Matthias K; Jäger, Bernhard; Aicher, Gabriele; Equiluz-Bruck, Susanne; Spiel, Alexander O; Funk, Georg-Christian; Gschwantler, Michael; Fasching, Peter; Wojta, Johann; Huber, Kurt.
  • Kaufmann CC; 3rd Medical Department with Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
  • Ahmed A; 3rd Medical Department with Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
  • Kassem M; 3rd Medical Department with Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
  • Freynhofer MK; 3rd Medical Department with Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
  • Jäger B; 3rd Medical Department with Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
  • Aicher G; Department of Laboratory Medicine, Wilhelminenhospital, Vienna, Austria.
  • Equiluz-Bruck S; Department of Hospital Hygiene, Wilhelminenhospital, Vienna, Austria.
  • Spiel AO; Department of Emergency Medicine, Wilhelminenhospital, Vienna, Austria.
  • Funk GC; Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Wilhelminenhospital, Vienna, Austria.
  • Gschwantler M; Department of Gastroenterology and Hepatology, Wilhelminenhospital, Vienna, Austria.
  • Fasching P; Department of Endocrinology and Rheumatology, Wilhelminenhospital, Vienna, Austria.
  • Wojta J; Department of Internal Medicine 2, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
  • Huber K; Core Facilities, Medical University of Vienna, Vienna, Austria.
Eur J Clin Invest ; 51(5): e13531, 2021 May.
Article in English | MEDLINE | ID: covidwho-1115019
ABSTRACT

BACKGROUND:

Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a strong prognostic marker in several inflammatory, respiratory and cardiovascular conditions, but has not been studied in COVID-19 yet.

METHODS:

This prospective, observational study of patients with COVID-19 infection was conducted from 6 June to 26 November 2020 in different wards of a tertiary hospital. MR-proANP, N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive cardiac troponin I levels on admission were collected and tested for their association with disease severity and 28-day mortality.

RESULTS:

A total of 213 eligible patients with COVID-19 were included in the final analyses of whom 13.2% (n = 28) died within 28 days. Median levels of MR-proANP at admission were significantly higher in nonsurvivors (307 pmol/L IQR, [161 - 532] vs 75 pmol/L [IQR, 43 - 153], P < .001) compared to survivors and increased with disease severity and level of hypoxaemia. The area under the ROC curve for MR-proANP predicting 28-day mortality was 0.832 (95% CI 0.753 - 0.912, P < .001). An optimal cut-off point of 160 pmol/L yielded a sensitivity of 82.1% and a specificity of 76.2%. MR-proANP was a significant predictor of 28-day mortality independent of clinical confounders, comorbidities and established prognostic markers of COVID-19 (HR 2.77, 95% CI 1.21 - 6.37; P = .016), while NT-proBNP failed to independently predict 28-day mortality and had a numerically lower AUC compared to MR-proANP.

CONCLUSION:

Higher levels of MR-proANP at admission are associated with disease severity of COVID-19 and act as a powerful and independent prognostic marker of 28-day mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Peptide Fragments / Mortality / Atrial Natriuretic Factor / Troponin I / Natriuretic Peptide, Brain / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Variants Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Clin Invest Year: 2021 Document Type: Article Affiliation country: Eci.13531

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Peptide Fragments / Mortality / Atrial Natriuretic Factor / Troponin I / Natriuretic Peptide, Brain / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Variants Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Clin Invest Year: 2021 Document Type: Article Affiliation country: Eci.13531