tetano
Editor, Senior Moderator
BMC Infect Dis
. 2023 May 8;23(1):305.
doi: 10.1186/s12879-023-08275-z. Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis
Na Wang[SUP] #[/SUP][SUP] 1 [/SUP], Lushan Liu[SUP] #[/SUP][SUP] 1 [/SUP], Wei He[SUP] 1 [/SUP], Na Shang[SUP] 1 [/SUP], Junyu Li[SUP] 1 [/SUP], Zhou Qin[SUP] 1 [/SUP], Xiaoxia Du[SUP] 2 [/SUP]
Affiliations
Background: Although there is increasing understanding of the changes in the laboratory parameters of Coronavirus disease 2019 (COVID-19), the correlation between circulating Mid-regional Proadrenomedullin (MR-proADM) and mortality of patients with COVID-19 is not fully understood. In this study, we conducted a systematic review and meta-analysis to evaluate the prognostic value of MR-proADM in patients with COVID-19.
Methods: The PubMed, Embase, Web of Science, Cochrane Library, Wanfang, SinoMed and Chinese National Knowledge Infrastructure (CNKI) databases were searched from 1 January 2020 to 20 March 2022 for relevant literature. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to assess quality bias, STATA was employed to pool the effect size by a random effects model, and potential publication bias and sensitivity analyses were performed.
Results: 14 studies comprising 1822 patients with COVID-19 met the inclusion criteria, there were 1145 (62.8%) males and 677 (31.2%) females, and the mean age was 63.8 ± 16.1 years. The concentration of MR-proADM was compared between the survivors and non-survivors in 9 studies and the difference was significant (P < 0.01), I[SUP]2[/SUP] = 46%. The combined sensitivity was 0.86 [0.73-0.92], and the combined specificity was 0.78 [0.68-0.86]. We drew the summary receiver operating characteristic (SROC) curve and calculated the area under curve (AUC) = 0.90 [0.87-0.92]. An increase of 1 nmol/L of MR-proADM was independently associated with a more than threefold increase in mortality (odds ratio (OR) 3.03, 95% confidence interval (CI) 2.26-4.06, I[SUP]2[/SUP] = 0.0%, P = 0.633). The predictive value of MR-proADM for mortality was better than many other biomarkers.
Conclusion: MR-proADM had a very good predictive value for the poor prognosis of COVID-19 patients. Increased levels of MR-proADM were independently associated with mortality in COVID-19 patients and may allow a better risk stratification.
Keywords: COVID-19; Meta-analysis; Mid-regional Proadrenomedullin; Mortality.
. 2023 May 8;23(1):305.
doi: 10.1186/s12879-023-08275-z. Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis
Na Wang[SUP] #[/SUP][SUP] 1 [/SUP], Lushan Liu[SUP] #[/SUP][SUP] 1 [/SUP], Wei He[SUP] 1 [/SUP], Na Shang[SUP] 1 [/SUP], Junyu Li[SUP] 1 [/SUP], Zhou Qin[SUP] 1 [/SUP], Xiaoxia Du[SUP] 2 [/SUP]
Affiliations
- PMID: 37158819
- DOI: 10.1186/s12879-023-08275-z
Background: Although there is increasing understanding of the changes in the laboratory parameters of Coronavirus disease 2019 (COVID-19), the correlation between circulating Mid-regional Proadrenomedullin (MR-proADM) and mortality of patients with COVID-19 is not fully understood. In this study, we conducted a systematic review and meta-analysis to evaluate the prognostic value of MR-proADM in patients with COVID-19.
Methods: The PubMed, Embase, Web of Science, Cochrane Library, Wanfang, SinoMed and Chinese National Knowledge Infrastructure (CNKI) databases were searched from 1 January 2020 to 20 March 2022 for relevant literature. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to assess quality bias, STATA was employed to pool the effect size by a random effects model, and potential publication bias and sensitivity analyses were performed.
Results: 14 studies comprising 1822 patients with COVID-19 met the inclusion criteria, there were 1145 (62.8%) males and 677 (31.2%) females, and the mean age was 63.8 ± 16.1 years. The concentration of MR-proADM was compared between the survivors and non-survivors in 9 studies and the difference was significant (P < 0.01), I[SUP]2[/SUP] = 46%. The combined sensitivity was 0.86 [0.73-0.92], and the combined specificity was 0.78 [0.68-0.86]. We drew the summary receiver operating characteristic (SROC) curve and calculated the area under curve (AUC) = 0.90 [0.87-0.92]. An increase of 1 nmol/L of MR-proADM was independently associated with a more than threefold increase in mortality (odds ratio (OR) 3.03, 95% confidence interval (CI) 2.26-4.06, I[SUP]2[/SUP] = 0.0%, P = 0.633). The predictive value of MR-proADM for mortality was better than many other biomarkers.
Conclusion: MR-proADM had a very good predictive value for the poor prognosis of COVID-19 patients. Increased levels of MR-proADM were independently associated with mortality in COVID-19 patients and may allow a better risk stratification.
Keywords: COVID-19; Meta-analysis; Mid-regional Proadrenomedullin; Mortality.