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Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study

The coronavirus disease 2019 (COVID-19) pandemic has placed a significant burden on hospitals worldwide. Objective biomarkers for early risk stratification and clinical management are still lacking. The aim of this work was to determine whether bioactive adrenomedullin can assist in the risk stratif...

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Autores principales: Simon, Tim-Philipp, Stoppe, Christian, Breuer, Thomas, Stiehler, Lara, Dreher, Michael, Kersten, Alexander, Kluge, Stefan, Karakas, Mahir, Zechendorf, Elisabeth, Marx, Gernot, Martin, Lukas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069401/
https://www.ncbi.nlm.nih.gov/pubmed/33924637
http://dx.doi.org/10.3390/jcm10081667
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author Simon, Tim-Philipp
Stoppe, Christian
Breuer, Thomas
Stiehler, Lara
Dreher, Michael
Kersten, Alexander
Kluge, Stefan
Karakas, Mahir
Zechendorf, Elisabeth
Marx, Gernot
Martin, Lukas
author_facet Simon, Tim-Philipp
Stoppe, Christian
Breuer, Thomas
Stiehler, Lara
Dreher, Michael
Kersten, Alexander
Kluge, Stefan
Karakas, Mahir
Zechendorf, Elisabeth
Marx, Gernot
Martin, Lukas
author_sort Simon, Tim-Philipp
collection PubMed
description The coronavirus disease 2019 (COVID-19) pandemic has placed a significant burden on hospitals worldwide. Objective biomarkers for early risk stratification and clinical management are still lacking. The aim of this work was to determine whether bioactive adrenomedullin can assist in the risk stratification and clinical management of critically ill COVID-19 patients. Fifty-three patients with confirmed COVID-19 were included in this prospective observational cohort study between March and April 2020. Bioactive adrenomedullin (bio-ADM) plasma concentration was measured daily for seven days after admission. The prognostic value and clinical significance of bio-ADM plasma levels were evaluated for the severity of respiratory failure, the need for extracorporeal organ support and outcome (28-day mortality). Bio-ADM levels increased with the severity of acute respiratory distress syndrome (ARDS; p < 0.001) and were significantly elevated in invasively ventilated patients (p = 0.006) and patients in need of extracorporeal membrane oxygenation (p = 0.040) or renal replacement therapy (RRT; p < 0.001) compared to patients without these conditions. Non-survivors showed significantly higher bio-ADM levels than survivors (p = 0.010). Bio-ADM levels predicted 28-day mortality (C-index 0.72, 95% confidence interval 0.56–0.87, p < 0.001). Bio-ADM plasma levels correlate with disease severity, the need for extracorporeal organ assistance, and outcome, and highlight the promising value of bio-ADM in the early risk stratification and management of patients with COVID-19.
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spelling pubmed-80694012021-04-26 Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study Simon, Tim-Philipp Stoppe, Christian Breuer, Thomas Stiehler, Lara Dreher, Michael Kersten, Alexander Kluge, Stefan Karakas, Mahir Zechendorf, Elisabeth Marx, Gernot Martin, Lukas J Clin Med Article The coronavirus disease 2019 (COVID-19) pandemic has placed a significant burden on hospitals worldwide. Objective biomarkers for early risk stratification and clinical management are still lacking. The aim of this work was to determine whether bioactive adrenomedullin can assist in the risk stratification and clinical management of critically ill COVID-19 patients. Fifty-three patients with confirmed COVID-19 were included in this prospective observational cohort study between March and April 2020. Bioactive adrenomedullin (bio-ADM) plasma concentration was measured daily for seven days after admission. The prognostic value and clinical significance of bio-ADM plasma levels were evaluated for the severity of respiratory failure, the need for extracorporeal organ support and outcome (28-day mortality). Bio-ADM levels increased with the severity of acute respiratory distress syndrome (ARDS; p < 0.001) and were significantly elevated in invasively ventilated patients (p = 0.006) and patients in need of extracorporeal membrane oxygenation (p = 0.040) or renal replacement therapy (RRT; p < 0.001) compared to patients without these conditions. Non-survivors showed significantly higher bio-ADM levels than survivors (p = 0.010). Bio-ADM levels predicted 28-day mortality (C-index 0.72, 95% confidence interval 0.56–0.87, p < 0.001). Bio-ADM plasma levels correlate with disease severity, the need for extracorporeal organ assistance, and outcome, and highlight the promising value of bio-ADM in the early risk stratification and management of patients with COVID-19. MDPI 2021-04-13 /pmc/articles/PMC8069401/ /pubmed/33924637 http://dx.doi.org/10.3390/jcm10081667 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Simon, Tim-Philipp
Stoppe, Christian
Breuer, Thomas
Stiehler, Lara
Dreher, Michael
Kersten, Alexander
Kluge, Stefan
Karakas, Mahir
Zechendorf, Elisabeth
Marx, Gernot
Martin, Lukas
Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study
title Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study
title_full Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study
title_fullStr Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study
title_full_unstemmed Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study
title_short Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study
title_sort prognostic value of bioactive adrenomedullin in critically ill patients with covid-19 in germany: an observational cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069401/
https://www.ncbi.nlm.nih.gov/pubmed/33924637
http://dx.doi.org/10.3390/jcm10081667
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