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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...

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Autores principales: de Montmollin, Etienne, Peoc’h, Katell, Marzouk, Mehdi, Ruckly, Stéphane, Wicky, Paul-Henri, Patrier, Juliette, Jaquet, Pierre, Sonneville, Romain, Bouadma, Lila, Timsit, Jean-François
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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