Eur J Clin Invest . Prognostic value of copeptin and mid-regional proadrenomedullin in COVID-19-hospitalized patients

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Eur J Clin Invest


. 2022 Feb 7;e13753.
doi: 10.1111/eci.13753. Online ahead of print.
Prognostic value of copeptin and mid-regional proadrenomedullin in COVID-19-hospitalized patients


Rita Indirli ^{1 2} , Alessandra Bandera ³ , Luca Valenti ⁴ , Ferruccio Ceriotti ⁵ , Adriana Di Modugno ⁵ , Mauro Tettamanti ⁶ , Roberta Gualtierotti ⁷ , Flora Peyvandi ⁷ , Nicola Montano ⁸ , Francesco Blasi ^{9 10} , Giorgio Costantino ¹¹ , Veronica Resi ¹ , Emanuela Orsi ¹ , Maura Arosio ^{1 2} , Giovanna Mantovani ^{1 2} , Emanuele Ferrante ¹ , COVID-19 Network Working Group



Collaborators, Affiliations

• PMID: 35128648
• DOI: 10.1111/eci.13753

Abstract

Background: Biomarkers are used for diagnosis, risk stratification and medical decisions. Copeptin and mid-regional proadrenomedullin (MR-proADM) are markers of stress and endothelial function, respectively, which have been studied in pneumonia, sepsis and septic shock. This study aimed to assess whether copeptin and MR-proADM could predict coronavirus disease 2019 (COVID-19) in-hospital outcomes, that is multi-system complications, length of stay and mortality.
Methods: Copeptin and MR-proADM were assessed at admission in 116 patients hospitalized with COVID-19. Data were retrospectively extracted from an online database. The primary endpoint was in-hospital mortality. The secondary endpoints were in-hospital complications, the composite outcome 'death, or admission to intensive care unit, or in-hospital complications', and length of stay. The predictive power was expressed as area under the receiver operator characteristic curve (AUROC).
Results: Copeptin was increased in non-survivors (median 29.7 [interquartile range 13.0-106.2] pmol/L) compared to survivors (10.9 [5.9-25.3] pmol/L, p < 0.01). The AUROC for mortality was 0.71, with a hazard ratio of 3.67 (p < 0.01) for copeptin values > 25.3 pmol/L. MR-proADM differentiated survivors (0.8 [0.6-1.1] nmol/L) from non-survivors (1.5 [1.1-2.8] nmol/L, p < 0.001) and yielded a AUROC of 0.79 and a hazard ratio of 7.02 (p < 0.001) for MR-proADM values > 1.0 nmol/L. Copeptin and MR-proADM predicted sepsis (AUROC 0.95 and 0.96 respectively), acute kidney injury (0.87 and 0.90), the composite outcome (0.69 and 0.75) and length of stay (r = 0.42, p < 0.001, and r = 0.46, p < 0.001).
Conclusions: Admission MR-proADM and copeptin may be implemented for early risk stratification in COVID-19-hospitalized patients to help identify those eligible for closer monitoring and care intensification.

Keywords: COVID-19; biomarkers; copeptin; mid-regional proadrenomedullin; mortality; prognosis.