Claudia Gregoriano1, Daniel Koch1, Alexander Kutz1, Sebastian Haubitz1,2, Anna Conen2,3, Luca Bernasconi4, Angelika Hammerer-Lercher4, Kordo Saeed5,6, Beat Mueller1,3, Philipp Schuetz1,3. 1. Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland. 2. Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Aarau, Switzerland. 3. Medical Faculty, University of Basel, Basel, Switzerland. 4. Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland. 5. Microbiology Innovation and Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK. 6. University of Southampton, School of Medicine Tremona Road Southampton, Southampton, UK.
Abstract
OBJECTIVES: Midregional pro-adrenomedullin (MR-proADM) is a vasoactive peptide with key roles in reducing vascular hyperpermeability and thereby improving endothelial stability during infection. While MR-proADM is useful for risk stratification in patients with sepsis, clinical data about prediction accuracy in patients with severe acute respiratory syndrome coronavirus 2 disease (COVID-19) is currently missing. METHODS: We included consecutively adult patients hospitalized for confirmed COVID-19 at a tertiary care center in Switzerland between February and April 2020. We investigated the association of MR-proADM levels with in-hospital mortality in logistic regression and discrimination analyses. RESULTS: Of 89 included COVID-19 patients, 19% (n=17) died while in the hospital. Median admission MR-proADM levels (nmol/L) were increased almost 1.5-fold increased in non-survivors compared to survivors (1.3 [interquartile range IQR 1.1-2.3]) vs. 0.8 [IQR 0.7-1.1]) and showed good discrimination (area under the curve 0.78). An increase of 1 nmol/L of admission MR-proADM was independently associated with a more than fivefold increase in in-hospital mortality (adjusted odds ratio of 5.5, 95% confidence interval 1.4-21.4, p=0.015). An admission MR-proADM threshold of 0.93 nmol/L showed the best prognostic accuracy for in-hospital mortality with a sensitivity of 93%, a specificity of 60% and a negative predictive value of 97%. Kinetics of follow-up MR-proADM provided further prognostic information for in-hospital treatment. CONCLUSIONS: Increased levels of MR-proADM on admission and during hospital stay were independently associated with in-hospital mortality and may allow a better risk stratification, and particularly rule-out of fatal outcome, in COVID-19 patients.
OBJECTIVES: Midregional pro-adrenomedullin (MR-proADM) is a vasoactive peptide with key roles in reducing vascular hyperpermeability and thereby improving endothelial stability during infection. While MR-proADM is useful for risk stratification in patients with sepsis, clinical data about prediction accuracy in patients with severe acute respiratory syndrome coronavirus 2 disease (COVID-19) is currently missing. METHODS: We included consecutively adult patients hospitalized for confirmed COVID-19 at a tertiary care center in Switzerland between February and April 2020. We investigated the association of MR-proADM levels with in-hospital mortality in logistic regression and discrimination analyses. RESULTS: Of 89 included COVID-19patients, 19% (n=17) died while in the hospital. Median admission MR-proADM levels (nmol/L) were increased almost 1.5-fold increased in non-survivors compared to survivors (1.3 [interquartile range IQR 1.1-2.3]) vs. 0.8 [IQR 0.7-1.1]) and showed good discrimination (area under the curve 0.78). An increase of 1 nmol/L of admission MR-proADM was independently associated with a more than fivefold increase in in-hospital mortality (adjusted odds ratio of 5.5, 95% confidence interval 1.4-21.4, p=0.015). An admission MR-proADM threshold of 0.93 nmol/L showed the best prognostic accuracy for in-hospital mortality with a sensitivity of 93%, a specificity of 60% and a negative predictive value of 97%. Kinetics of follow-up MR-proADM provided further prognostic information for in-hospital treatment. CONCLUSIONS: Increased levels of MR-proADM on admission and during hospital stay were independently associated with in-hospital mortality and may allow a better risk stratification, and particularly rule-out of fatal outcome, in COVID-19patients.
Authors: Jos A H van Oers; Sjaak Pouwels; Dharmanand Ramnarain; Yvette Kluiters; Judith A P Bons; Dylan W de Lange; Harm-Jan de Grooth; Armand R J Girbes Journal: Int J Obes (Lond) Date: 2022-07-15 Impact factor: 5.551
Authors: Claudia Gregoriano; Alexandra Molitor; Ellen Haag; Alexander Kutz; Daniel Koch; Sebastian Haubitz; Anna Conen; Luca Bernasconi; Angelika Hammerer-Lercher; Christoph A Fux; Beat Mueller; Philipp Schuetz Journal: J Endocr Soc Date: 2021-03-17
Authors: Blanca Valenzuela-Méndez; Francisco Valenzuela-Sánchez; Juan Francisco Rodríguez-Gutiérrez; Rafael Bohollo-de-Austria; Ángel Estella; Pilar Martínez-García; María Ángela González-García; Jordi Rello Journal: J Pers Med Date: 2022-01-10
Authors: Christoph C Kaufmann; Amro Ahmed; Achim Leo Burger; Marie Muthspiel; Bernhard Jäger; Johann Wojta; Kurt Huber Journal: Cells Date: 2022-03-08 Impact factor: 6.600