MR‐proADM as marker of endotheliitis predicts COVID‐19 severity

Abstract

Background: Early identification of patients at high risk of progression to severe COVID-19 constituted an unsolved challenge. Although growing evidence demonstrates a direct association between endotheliitis and severe COVID-19, the role of endothelial damage biomarkers has been scarcely studied. We investigated the relationship between circulating mid-regional proadrenomedullin (MR-proADM) levels, a biomarker of endothelial dysfunction, and prognosis of SARS-CoV-2-infected patients. Methods: Prospective observational study enrolling adult patients with confirmed COVID-19. On admission to emergency department, a blood sample was drawn for laboratory test analysis. Primary and secondary endpoints were 28-day all-cause mortality and severe COVID-19 progression. Area under the curve (AUC) and multivariate regression analysis were employed to assess the association of the biomarker with the established endpoints. Results: A total of 99 patients were enrolled. During hospitalization, 25 (25.3%) cases progressed to severe disease and the 28-day mortality rate was of 14.1%.

Endothelium-associated biomarkers mid-regional proadrenomedullin and C-terminal proendothelin-1 have good ability to predict 28-day mortality in critically ill patients with SARS-CoV-2 pneumonia: A prospective cohort study

“…Baseline MR-proADM performed well in predicting 28-day mortality in comparison with APACHE II and Simplified Acute Physiology Score II (SAPSII) when all patients admitted to the ICU were included [ 23 ]. The value of MR-proADM as prognostic marker in adult patients hospitalized with SARS-CoV-2 infection was studied in several observational studies [ [24] , [25] , [26] , [27] , [28] , [29] ]. Increased levels of MR-proADM were independently associated with mortality [ [24] , [25] , [26] , [27] , [28] , [29] ].…”

“…The value of MR-proADM as prognostic marker in adult patients hospitalized with SARS-CoV-2 infection was studied in several observational studies [ [24] , [25] , [26] , [27] , [28] , [29] ]. Increased levels of MR-proADM were independently associated with mortality [ [24] , [25] , [26] , [27] , [28] , [29] ]. However, not all patients were admitted to the ICU [ 24 , 25 , 28 , 29 ].…”

“…Increased levels of MR-proADM were independently associated with mortality [ [24] , [25] , [26] , [27] , [28] , [29] ]. However, not all patients were admitted to the ICU [ 24 , 25 , 28 , 29 ]. CT-proET-1 was studied in non-COVID-19 patients admitted to the ED with CAP [ 14 , 16 ].…”

Circulating MR-proADM levels, as an indicator of endothelial dysfunction, for early risk stratification of mid-term mortality in COVID-19 patients

“…Preliminary results in small scale studies including patients on first wave suggest a potential role for MR-proADM regarding prognosis [García de Guadiana-Romualdo et al,2021 ; Gregoriano et al, 2021 ; Sozio et al, 2021 ; Montrucchio et al, 2020], but these findings need confirmation in larger studies trials [Saeed et al, 2021] . Noteworthy, most of these studies focused on a short follow-up period to outcome (28/30 days) [ García de Guadiana-Romualdo et al, 2021 ; Gregoriano et al, 2021 ].…”

“…Preliminary results in small scale studies including patients on first wave suggest a potential role for MR-proADM regarding prognosis [García de Guadiana-Romualdo et al,2021 ; Gregoriano et al, 2021 ; Sozio et al, 2021 ; Montrucchio et al, 2020], but these findings need confirmation in larger studies trials [Saeed et al, 2021] . Noteworthy, most of these studies focused on a short follow-up period to outcome (28/30 days) [ García de Guadiana-Romualdo et al, 2021 ; Gregoriano et al, 2021 ]. Finally, differences in the predictive accuracies of biomarkers as D-dimer or IL-6 between the first and second wave have been reported, reflecting a different disease stage of patients on arrival to hospital [Mollinedo-Gajate et al, 2021] and a lower severity during the second wave [Fan et al, 2020] , conditions both affecting to the accuracy of biomarkers.…”