J Med Virol . High value of Mid-regional proAdrenomedullin in COVID-19: a marker of widespread endothelial damage, disease severity and mortality

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J Med Virol


. 2020 Nov 17.
doi: 10.1002/jmv.26676. Online ahead of print.
High value of Mid-regional proAdrenomedullin in COVID-19: a marker of widespread endothelial damage, disease severity and mortality


Silvia Spoto ¹ , Felice E Agr? ² , Federica Sambuco ³ , Francesco Travaglino ³ , Emanuele Valeriani ¹ , Marta Fogolari ⁴ , Fabio Mangiacapra ⁵ , Sebastiano Costantino ¹ , Massimo Ciccozzi ⁶ , Silvia Angeletti ⁴



Affiliations

• PMID: 33200824
• DOI: 10.1002/jmv.26676

Abstract

The widespread endothelial damage due to severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) may lead to a disruption of the adrenomedullin (ADM) system responsible for vascular leakage, increased inflammatory status, and microvascular alteration with multi-organs dysfunction. The aim of this study was to evaluate the role of Mid-regional proAdrenomedullin (MR-proADM) as a marker of SARS CoV2-related widespread endothelial damage, clinically identified by organs damage, disease severity and mortality. Patients with SARS-CoV2 infection has been prospectively enrolled and demographic characteristic, clinical and laboratory data has been evaluated. In the overall population, 58% developed acute respiratory distress syndrome (ARDS), 23.3% of patients died, 6.5% acute cardiac injury, 1.4% of patients developed acute ischemic stroke, 21.2% acute kidney injury, 11.8% acute liver damage, and 5.4% septic shock. The best MR-proADM cut-off values for ARDS development and mortality prediction were 3.04 nmol/L and 2 nmol/L, respectively. Patients presenting with MR-proADM values ≥ 2 nmol/L showed a significantly higher mortality risk. In conclusion, MR-proADM values ≥ 2 nmol/l identify those patients with high mortality risk related to a multiorgan dysfunction syndrome. These patients must be carefully evaluated and considered for an intensive therapeutic approach. This article is protected by copyright. All rights reserved.

Keywords: COVID-19; SARS virus; acute respiratory distress syndrome; adrenomedullin; multiple organ dysfunction syndrome.