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Proadrenomedullin in the Management of COVID-19 Critically Ill Patients in Intensive Care Unit: A Systematic Review and Meta-Analysis of Evidence and Uncertainties in Existing Literature.
Montrucchio, Giorgia; Balzani, Eleonora; Lombardo, Davide; Giaccone, Alice; Vaninetti, Anna; D'Antonio, Giulia; Rumbolo, Francesca; Mengozzi, Giulio; Brazzi, Luca.
  • Montrucchio G; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
  • Balzani E; Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Corso Dogliotti 14, 10126 Turin, Italy.
  • Lombardo D; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
  • Giaccone A; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
  • Vaninetti A; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
  • D'Antonio G; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
  • Rumbolo F; Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
  • Mengozzi G; Clinical Biochemistry Laboratory, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy.
  • Brazzi L; Clinical Biochemistry Laboratory, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy.
J Clin Med ; 11(15)2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-1969338
ABSTRACT
Mid-regional proadrenomedullin (MR-proADM) is a new biomarker of endothelial damage and its clinical use is increasing in sepsis and respiratory infections and recently in SARS-CoV-2 infection. We conducted a systematic review and meta-analysis to clarify the use of MR-proADM in severe COVID-19 disease. After Pubmed, Embase, and Scopus search, registries, and gray literature, deduplication, and selection of full-texts, we found 21 studies addressing the use of proadrenomedullin in COVID-19. All the studies were published between 2020 and 2022 from European countries. A total of 9 studies enrolled Intensive Care Unit (ICU) patients, 4 were conducted in the Emergency Department, and 8 had mixed populations. Regarding the ICU critically ill patients, 4 studies evaluating survival as primary outcome were available, of which 3 reported completed data. Combining the selected studies in a meta-analysis, a total of 252 patients were enrolled; of these, 182 were survivors and 70 were non-survivors. At the admission to the ICU, the average MR-proADM level in survivor patients was 1.01 versus 1.64 in non-survivor patients. The mean differences of MR-proADM values in survivors vs. non-survivors was -0.96 (95% CI from -1.26, to -0.65). Test for overall effect Z = 6.19 (p < 0.00001) and heterogeneity was I2 = 0%. MR-proADM ICU admission levels seem to predict mortality among the critical COVID-19 population. Further, prospective studies, focused on critically ill patients and investigating a reliable MR-proADM cut-off, are needed to provide adequate guidance to its use in severe COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11154543

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11154543