Abstract:Introduction: Various biomarkers are used to evaluate the severity and prognosis of community acquired pneumonia (CAP). Objectives: To study and compare the prognostic value of MR-proADM, РСТ and CRP in predicting the severity and outcome of CAP. Methods: A prospective cohort study of 92 patients hospitalized with CAP in the Clinic of Pneumology and Phthisiatrics of MHAT "Saint Marina"-Varna in 2015 was conducted. The biomarkers were measured on admission. Midregional proadrenomedullin (MR-proADM) and procalcitonin (РСТ) were measured by standard ELISA, and C-reactive protein (CRP) was determined by latex-enhanced immunoturbidimetric assay. CAP severity was assessed by CURB-65. Results: Patients were on average 59.2±16.8 years of age; 68.5% of them were male. The in-hospital mortality rate was 7.6%. The three biomarkers MR-proADM, РСТ and CRP were significantly higher in non-survivors compared to survivors (0.918±0.045 ng/ml vs. 0.397±0.269ng/ml, р<0.001; 2.14±0.60ng/ml vs. 1.12±0.68ng/ml, р<0.001 and 215.12±96.39 mg/L vs.175.74±221.5mg/L, p<0.05 respectively). In patients who needed intensive care, the biomarkers were also significantly higher than those in patients treated in the general hospital unit (0.509±0.336ng/ml vs. 0.414±0.28ng/ml, р<0.05; 1.92±0.76 ng/ml vs. 1.15±0.70ng/ml, p<0.05 and 221.98±100.34 mg/L vs. 165.31±122.84 mg/L, p<0.05 resp.). MR-proADM and РСТ showed a moderate correlation with the CURB-65 (r=0.33, p<0.01 and r=0.30, p<0.05 respectively). CRP did not correlate with the CURB-65 (r=0.10, p>0.05). Conclusion: MR-proADM, РСТ and CRP were significantly higher in non-survivors and in patients treated in the intensive care unit. MR-proADM and РСТ showed a moderate correlation with the CURB-65, while the correlation coefficient for MR-proADM was higher. CRP did not correlate with the CURB-65.UDC Classification: 616-01; DOI: http://dx

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