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Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS
Mid-regional proadrenomedullin (MR-proADM) protects against endothelial permeability and has been associated with prognosis in bacterial sepsis. As endothelial dysfunction is central in the pathophysiology of severe SARS-CoV-2 infection, we sought to evaluate MR-proADM both as a prognostic biomarker...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495198/ https://www.ncbi.nlm.nih.gov/pubmed/36139946 http://dx.doi.org/10.3390/antibiotics11091166 |
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author | de Montmollin, Etienne Peoc’h, Katell Marzouk, Mehdi Ruckly, Stéphane Wicky, Paul-Henri Patrier, Juliette Jaquet, Pierre Sonneville, Romain Bouadma, Lila Timsit, Jean-François |
author_facet | de Montmollin, Etienne Peoc’h, Katell Marzouk, Mehdi Ruckly, Stéphane Wicky, Paul-Henri Patrier, Juliette Jaquet, Pierre Sonneville, Romain Bouadma, Lila Timsit, Jean-François |
author_sort | de Montmollin, Etienne |
collection | PubMed |
description | Mid-regional proadrenomedullin (MR-proADM) protects against endothelial permeability and has been associated with prognosis in bacterial sepsis. As endothelial dysfunction is central in the pathophysiology of severe SARS-CoV-2 infection, we sought to evaluate MR-proADM both as a prognostic biomarker and as a marker of bacterial superinfection. Consecutive patients admitted to the ICU for severe SARS-CoV-2 pneumonia were prospectively included and serum was bio-banked on days 1, 3, and 7. MR-proADM levels were measured blindly from clinical outcomes in batches at the end of follow-up. Among the 135 patients included between April 2020 and May 2021, 46 (34.1%) had died at day 60. MR-proADM levels on days 1, 3, and 7 were significantly higher in day-60 non-survivors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve (0.744, p < 0.001) of day-1 MR-proADM compared favorably with the AUC ROC curve of day-1 procalcitonin (0.691, p < 0.001). Serial MR-proADM measurements on days 3 and 7 may add prognostic information. After adjusting for CRP, LDH, and lymphocyte values, day-1 MR-proADM remained significantly associated with day-60 mortality. MR-proADM concentrations were significantly higher in patients with respiratory superinfections (on days 3 and 7) and bloodstream infections (on days 1, 3, and 7) than in patients without infection. Our results suggest that MR-proADM is a good predictor of outcome in severe SARS-CoV-2 infection and could be a useful tool to assess bacterial superinfection in COVID-19 patients. |
format | Online Article Text |
id | pubmed-9495198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94951982022-09-23 Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS de Montmollin, Etienne Peoc’h, Katell Marzouk, Mehdi Ruckly, Stéphane Wicky, Paul-Henri Patrier, Juliette Jaquet, Pierre Sonneville, Romain Bouadma, Lila Timsit, Jean-François Antibiotics (Basel) Article Mid-regional proadrenomedullin (MR-proADM) protects against endothelial permeability and has been associated with prognosis in bacterial sepsis. As endothelial dysfunction is central in the pathophysiology of severe SARS-CoV-2 infection, we sought to evaluate MR-proADM both as a prognostic biomarker and as a marker of bacterial superinfection. Consecutive patients admitted to the ICU for severe SARS-CoV-2 pneumonia were prospectively included and serum was bio-banked on days 1, 3, and 7. MR-proADM levels were measured blindly from clinical outcomes in batches at the end of follow-up. Among the 135 patients included between April 2020 and May 2021, 46 (34.1%) had died at day 60. MR-proADM levels on days 1, 3, and 7 were significantly higher in day-60 non-survivors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve (0.744, p < 0.001) of day-1 MR-proADM compared favorably with the AUC ROC curve of day-1 procalcitonin (0.691, p < 0.001). Serial MR-proADM measurements on days 3 and 7 may add prognostic information. After adjusting for CRP, LDH, and lymphocyte values, day-1 MR-proADM remained significantly associated with day-60 mortality. MR-proADM concentrations were significantly higher in patients with respiratory superinfections (on days 3 and 7) and bloodstream infections (on days 1, 3, and 7) than in patients without infection. Our results suggest that MR-proADM is a good predictor of outcome in severe SARS-CoV-2 infection and could be a useful tool to assess bacterial superinfection in COVID-19 patients. MDPI 2022-08-29 /pmc/articles/PMC9495198/ /pubmed/36139946 http://dx.doi.org/10.3390/antibiotics11091166 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 de Montmollin, Etienne Peoc’h, Katell Marzouk, Mehdi Ruckly, Stéphane Wicky, Paul-Henri Patrier, Juliette Jaquet, Pierre Sonneville, Romain Bouadma, Lila Timsit, Jean-François Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS |
title | Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS |
title_full | Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS |
title_fullStr | Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS |
title_full_unstemmed | Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS |
title_short | Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS |
title_sort | mid-regional pro-adrenomedullin as a prognostic factor for severe covid-19 ards |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495198/ https://www.ncbi.nlm.nih.gov/pubmed/36139946 http://dx.doi.org/10.3390/antibiotics11091166 |
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