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Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study

Coagulopathy and immune dysregulation have been identified as important causes of adverse outcomes in coronavirus disease (COVID-19). Mid-region proadrenomedullin (MR-proADM) is associated with endothelial damage and has recently been proposed as a prognostic factor in COVID-19. In non-COVID-19 immu...

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Autores principales: Mangioni, Davide, Oggioni, Massimo, Chatenoud, Liliane, Liparoti, Arianna, Uceda Renteria, Sara, Alagna, Laura, Biscarini, Simona, Bolis, Matteo, Di Modugno, Adriana, Mussa, Marco, Renisi, Giulia, Ungaro, Riccardo, Muscatello, Antonio, Gori, Andrea, Ceriotti, Ferruccio, Bandera, Alessandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9414973/
https://www.ncbi.nlm.nih.gov/pubmed/36016305
http://dx.doi.org/10.3390/v14081683
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author Mangioni, Davide
Oggioni, Massimo
Chatenoud, Liliane
Liparoti, Arianna
Uceda Renteria, Sara
Alagna, Laura
Biscarini, Simona
Bolis, Matteo
Di Modugno, Adriana
Mussa, Marco
Renisi, Giulia
Ungaro, Riccardo
Muscatello, Antonio
Gori, Andrea
Ceriotti, Ferruccio
Bandera, Alessandra
author_facet Mangioni, Davide
Oggioni, Massimo
Chatenoud, Liliane
Liparoti, Arianna
Uceda Renteria, Sara
Alagna, Laura
Biscarini, Simona
Bolis, Matteo
Di Modugno, Adriana
Mussa, Marco
Renisi, Giulia
Ungaro, Riccardo
Muscatello, Antonio
Gori, Andrea
Ceriotti, Ferruccio
Bandera, Alessandra
author_sort Mangioni, Davide
collection PubMed
description Coagulopathy and immune dysregulation have been identified as important causes of adverse outcomes in coronavirus disease (COVID-19). Mid-region proadrenomedullin (MR-proADM) is associated with endothelial damage and has recently been proposed as a prognostic factor in COVID-19. In non-COVID-19 immunocompromised patients, low in vitro interferon gamma (IFNγ) production correlates with infection risk and mortality. This prospective, monocentric, observational study included adult patients consecutively admitted with radiologic evidence of COVID-19 pneumonia and respiratory failure. MR-proADM and in vitro IFNγ production were measured at T0 (day 1 from admission) and T1 (day 7 from enrollment). One hundred patients were enrolled. Thirty-six percent were females, median age 65 (Q1–Q3 54.5–75) years, and 58% had ≥1 comorbidity. Only 16 patients had received COVID-19 vaccination before hospitalization. At admission, the median PaO2:FiO2 ratio was 241 (157–309) mmHg. In-hospital mortality was 13%. MR-proADM levels differed significantly between deceased and survivors both at T0 (1.41 (1.12–1.77) nmol/L vs. 0.79 (0.63–1.03) nmol/L, p < 0.001) and T1 (1.67 (1.08–1.96) nmol/L vs. 0.66 (0.53–0.95) nmol/L, p < 0.001). In vitro IFNγ production at T0 and T1 did not vary between groups. When only the subset of non-vaccinated patients was considered, both biomarkers at T1 resulted significantly associated with in-hospital mortality. AUROC for MR-proADM at T0 to predict in-hospital mortality was 0.87 (95%CI 0.79–0.94), with the best cut-off point at 1.04 nmol/L (92% sensitivity, 75% specificity and 98% negative predictive value). In patients with COVID-19 pneumonia and different degrees of respiratory failure, MR-proADM at admission and during hospitalization resulted strongly associated with in-hospital mortality. Low in vitro IFNγ production after the first week of hospitalization was associated with mortality in non-vaccinated patients possibly identifying the subgroup characterized by a higher degree of immune suppression.
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spelling pubmed-94149732022-08-27 Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study Mangioni, Davide Oggioni, Massimo Chatenoud, Liliane Liparoti, Arianna Uceda Renteria, Sara Alagna, Laura Biscarini, Simona Bolis, Matteo Di Modugno, Adriana Mussa, Marco Renisi, Giulia Ungaro, Riccardo Muscatello, Antonio Gori, Andrea Ceriotti, Ferruccio Bandera, Alessandra Viruses Article Coagulopathy and immune dysregulation have been identified as important causes of adverse outcomes in coronavirus disease (COVID-19). Mid-region proadrenomedullin (MR-proADM) is associated with endothelial damage and has recently been proposed as a prognostic factor in COVID-19. In non-COVID-19 immunocompromised patients, low in vitro interferon gamma (IFNγ) production correlates with infection risk and mortality. This prospective, monocentric, observational study included adult patients consecutively admitted with radiologic evidence of COVID-19 pneumonia and respiratory failure. MR-proADM and in vitro IFNγ production were measured at T0 (day 1 from admission) and T1 (day 7 from enrollment). One hundred patients were enrolled. Thirty-six percent were females, median age 65 (Q1–Q3 54.5–75) years, and 58% had ≥1 comorbidity. Only 16 patients had received COVID-19 vaccination before hospitalization. At admission, the median PaO2:FiO2 ratio was 241 (157–309) mmHg. In-hospital mortality was 13%. MR-proADM levels differed significantly between deceased and survivors both at T0 (1.41 (1.12–1.77) nmol/L vs. 0.79 (0.63–1.03) nmol/L, p < 0.001) and T1 (1.67 (1.08–1.96) nmol/L vs. 0.66 (0.53–0.95) nmol/L, p < 0.001). In vitro IFNγ production at T0 and T1 did not vary between groups. When only the subset of non-vaccinated patients was considered, both biomarkers at T1 resulted significantly associated with in-hospital mortality. AUROC for MR-proADM at T0 to predict in-hospital mortality was 0.87 (95%CI 0.79–0.94), with the best cut-off point at 1.04 nmol/L (92% sensitivity, 75% specificity and 98% negative predictive value). In patients with COVID-19 pneumonia and different degrees of respiratory failure, MR-proADM at admission and during hospitalization resulted strongly associated with in-hospital mortality. Low in vitro IFNγ production after the first week of hospitalization was associated with mortality in non-vaccinated patients possibly identifying the subgroup characterized by a higher degree of immune suppression. MDPI 2022-07-30 /pmc/articles/PMC9414973/ /pubmed/36016305 http://dx.doi.org/10.3390/v14081683 Text en © 2022 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
Mangioni, Davide
Oggioni, Massimo
Chatenoud, Liliane
Liparoti, Arianna
Uceda Renteria, Sara
Alagna, Laura
Biscarini, Simona
Bolis, Matteo
Di Modugno, Adriana
Mussa, Marco
Renisi, Giulia
Ungaro, Riccardo
Muscatello, Antonio
Gori, Andrea
Ceriotti, Ferruccio
Bandera, Alessandra
Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study
title Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study
title_full Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study
title_fullStr Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study
title_full_unstemmed Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study
title_short Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study
title_sort prognostic value of mid-region proadrenomedullin and in vitro interferon gamma production for in-hospital mortality in patients with covid-19 pneumonia and respiratory failure: an observational prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9414973/
https://www.ncbi.nlm.nih.gov/pubmed/36016305
http://dx.doi.org/10.3390/v14081683
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