tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Aug 24;9(9)
fac423.
doi: 10.1093/ofid/ofac423. eCollection 2022 Sep.
Mid-regional Proadrenomedullin Biomarker Predicts Coronavirus Disease 2019 Clinical Outcomes: A US-Based Cohort Study
Natalie J Atallah[SUP] 1 2 3 [/SUP], Vahe S Panossian[SUP] 4 [/SUP], Christine J Atallah[SUP] 5 [/SUP], Andrej Schwabe[SUP] 6 [/SUP], Sascha Johannes[SUP] 6 [/SUP], Jan Wiemer[SUP] 6 [/SUP], Michael K Mansour[SUP] 1 2 3 [/SUP]
Affiliations
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: COVID-19; ICU; MR-proADM; biomarkers; viral pneumonia.
. 2022 Aug 24;9(9)
fac423.doi: 10.1093/ofid/ofac423. eCollection 2022 Sep.
Mid-regional Proadrenomedullin Biomarker Predicts Coronavirus Disease 2019 Clinical Outcomes: A US-Based Cohort Study
Natalie J Atallah[SUP] 1 2 3 [/SUP], Vahe S Panossian[SUP] 4 [/SUP], Christine J Atallah[SUP] 5 [/SUP], Andrej Schwabe[SUP] 6 [/SUP], Sascha Johannes[SUP] 6 [/SUP], Jan Wiemer[SUP] 6 [/SUP], Michael K Mansour[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 36072696
- PMCID: PMC9439577
- DOI: 10.1093/ofid/ofac423
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: COVID-19; ICU; MR-proADM; biomarkers; viral pneumonia.