Your browser doesn't support javascript.
Effectiveness of mid-regional pro-adrenomedullin (MR-proADM) as prognostic marker in COVID-19 critically ill patients: An observational prospective study.
Montrucchio, Giorgia; Sales, Gabriele; Rumbolo, Francesca; Palmesino, Filippo; Fanelli, Vito; Urbino, Rosario; Filippini, Claudia; Mengozzi, Giulio; Brazzi, Luca.
  • Montrucchio G; Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, 'Città della Salute e della Scienza' Hospital, Turin, Italy.
  • Sales G; Department of Surgical Science, University of Turin, Turin, Italy.
  • Rumbolo F; Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, 'Città della Salute e della Scienza' Hospital, Turin, Italy.
  • Palmesino F; Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 'Città della Salute e della Scienza' Hospital, Turin, Italy.
  • Fanelli V; Department of Surgical Science, University of Turin, Turin, Italy.
  • Urbino R; Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, 'Città della Salute e della Scienza' Hospital, Turin, Italy.
  • Filippini C; Department of Surgical Science, University of Turin, Turin, Italy.
  • Mengozzi G; Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, 'Città della Salute e della Scienza' Hospital, Turin, Italy.
  • Brazzi L; Department of Surgical Science, University of Turin, Turin, Italy.
PLoS One ; 16(2): e0246771, 2021.
Article in English | MEDLINE | ID: covidwho-1115297
ABSTRACT

OBJECTIVE:

To test the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting mortality in COVID-19-ICU-patients.

METHODS:

All consecutive COVID-19 adult patients admitted between March and June 2020 to the ICU of a referral, university hospital in Northern-Italy were enrolled. MR-proADM and routine laboratory test were measured within 48 hours from ICU admission, on day 3, 7 and 14. Survival curves difference with MR-proADM cut-off set to 1.8 nmol/L were tested using log-rank test. Predictive ability was compared using area under the curve and 95% confidence interval of different receiver-operating characteristics curves.

RESULTS:

57 patients were enrolled. ICU and overall mortality were 54.4%. At admission, lymphocytopenia was present in 86% of patients; increased D-dimer and CRP levels were found in 84.2% and 87.7% of patients respectively, while PCT values > 0.5 µg/L were observed in 47.4% of patients. MR-proADM, CRP and LDH were significantly different between surviving and non-surviving patients and over time, while PCT, D-dimer and NT-pro-BNP did not show any difference between the groups and over time; lymphocytes were different between surviving and non-surviving patients only. MR-proADM was higher in dying patients (2.65±2.33vs1.18±0.47, p<0.001) and a higher mortality characterized patients with MR-proADM >1.8 nmol/L (p = 0.016). The logistic regression model adjusted for age, gender, cardiovascular disease, diabetes mellitus and PCT values confirmed an odds ratio = 10.3 [95%CI1.9-53.6] (p = 0.006) for MR-proADM >1.8 nmol/L and = 22.2 [95%CI1.6-316.9] (p = 0.022) for cardiovascular disease. Overall, MR-proADM had the best predictive ability (AUC = 0.85 [95%CI0.78-0.90]).

CONCLUSIONS:

In COVID-19 ICU-patients, MR-proADM seems to have constantly higher values in non-survivor patients and predict mortality more precisely than other biomarkers. Repeated MR-proADM measurement may support a rapid and effective decision-making. Further studies are needed to better explain the mechanisms responsible of the increase in MR-proADM in COVID-19 patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / Adrenomedullin / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0246771

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / Adrenomedullin / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0246771