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Mid-regional Proadrenomedullin Biomarker Predicts Coronavirus Disease 2019 Clinical Outcomes: A US-Based Cohort Study.
Atallah, Natalie J; Panossian, Vahe S; Atallah, Christine J; Schwabe, Andrej; Johannes, Sascha; Wiemer, Jan; Mansour, Michael K.
  • Atallah NJ; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Panossian VS; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
  • Atallah CJ; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Schwabe A; Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
  • Johannes S; Faculty of Medicine, University of Balamand, Beirut, Lebanon.
  • Wiemer J; B·R·A·H·M·S GmbH, part of Thermo Fisher Scientific, Hennigsdorf, Germany.
  • Mansour MK; B·R·A·H·M·S GmbH, part of Thermo Fisher Scientific, Hennigsdorf, Germany.
Open Forum Infect Dis ; 9(9): ofac423, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2018042
ABSTRACT

Background:

Mid-regional proadrenomedullin (MR-proADM) is a biomarker released following endothelial damage. Studies have shown a correlation in predicting coronavirus disease 2019 (COVID-19) outcomes with MR-proADM levels. Our study aimed to investigate baseline MR-proADM as a predictor of a wider range of clinical outcomes of varying severity in patients admitted with COVID-19, and to compare to other biomarkers.

Methods:

Data from the Boston Area COVID-19 Consortium (BACC) Bay Tocilizumab Trial was used in this study. Patients with biomarker determinations, and not admitted to the intensive care unit (ICU) on admission, were included. MR-proADM cutoff of 0.87 nmol/L was assessed in predicting clinical outcomes.

Results:

Of 182 patients, 11.0% were mechanically ventilated or dead within 28 days. Of patients with MR-proADM >0.87 nmol/L, 21.1% were mechanically ventilated or dead within 28 days, compared with 4.5% of those with MR-proADM ≤0.87 nmol/L (P < .001). The sensitivity, specificity, negative predictive value, and positive predictive value of MR-proADM cutoff of 0.87 nmol/L in predicting mechanical ventilation or death were 75%, 65%, 95%, and 21%, respectively, with an area under the receiver operating characteristic curve of 0.76. On multivariable logistic regression analysis, MR-proADM >0.87 nmol/L was independently associated with mechanical ventilation or death, ICU admission, prolonged hospitalization beyond day 4, and day 4 COVID-19 ordinal scale equal to or worse than day 1.

Conclusions:

MR-proADM functions as a valuable biomarker for the early risk stratification and detection of severe disease progression of patients with COVID-19. In the prediction of death, MR-proADM performed better compared to many other commonly used biomarkers.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid