The University of Southampton
University of Southampton Institutional Repository

MR-proADM as prognostic factor of outcome in COVID-19 patients

MR-proADM as prognostic factor of outcome in COVID-19 patients
MR-proADM as prognostic factor of outcome in COVID-19 patients

Mid Regional pro-ADM (MR-proADM) is a promising novel biomarker in the evaluation of deteriorating patients and an emergent prognosis factor in patients with sepsis, septic shock and organ failure. It can be induced by bacteria, fungi or viruses. We hypothesized that the assessment of MR-proADM, with or without other inflammatory cytokines, as part of a clinical assessment of COVID-19 patients at hospital admission, may assist in identifying those likely to develop severe disease. A pragmatic retrospective analysis was performed on a complete data set from 111 patients admitted to Udine University Hospital, in northern Italy, from 25th March to 15th May 2020, affected by SARS-CoV-2 pneumonia. Clinical scoring systems (SOFA score, WHO disease severity class, SIMEU clinical phenotype), cytokines (IL-6, IL-1b, IL-8, TNF-α), and MR-proADM were measured. Demographic, clinical and outcome data were collected for analysis. At multivariate analysis, high MR-proADM levels were significantly associated with negative outcome (death or orotracheal intubation, IOT), with an odds ratio of 4.284 [1.893–11.413], together with increased neutrophil count (OR = 1.029 [1.011–1.049]) and WHO disease severity class (OR = 7.632 [5.871–19.496]). AUROC analysis showed a good discriminative performance of MR-proADM (AUROC: 0.849 [95% Cl 0.771–0.730]; p < 0.0001). The optimal value of MR-proADM to discriminate combined event of death or IOT is 0.895 nmol/l, with a sensitivity of 0.857 [95% Cl 0.728–0.987] and a specificity of 0.687 [95% Cl 0.587–0.787]. This study shows an association between MR-proADM levels and the severity of COVID-19. The assessment of MR-proADM combined with clinical scoring systems could be of great value in triaging, evaluating possible escalation of therapies, and admission avoidance or inclusion into trials. Larger prospective and controlled studies are needed to confirm these findings.

Adrenomedullin/blood, Aged, Biomarkers/blood, COVID-19/blood, Female, Humans, Male, Middle Aged, Peptide Fragments/blood, Prognosis, Protein Precursors/blood, Retrospective Studies
2045-2322
Sozio, Emanuela
d51c79ea-9349-45a0-8bd5-5fe4fd38265f
Tascini, Carlo
3178f7ca-5c39-408c-ad5d-5cb7164f987a
Fabris, Martina
ad0cf734-f7a0-472f-927e-f26b44837bee
D’Aurizio, Federica
a3a499c6-7210-4089-9f5f-67fffc2067bd
De Carlo, Chiara
57b9d9aa-1306-4d52-ace6-7b20f01b944f
Graziano, Elena
730410b8-36ba-4745-b0df-66922d355be7
Bassi, Flavio
0af5c47b-f768-4cda-9167-0fc2fc4677f7
Sbrana, Francesco
d795993c-5790-4ba2-bfaf-09496c8b23e0
Ripoli, Andrea
7c0ac6ca-31d2-4561-a708-418850bb708e
Pagotto, Alberto
4fdf47ba-7e8a-4882-982c-4b8d9fc46e16
Giacinta, Alessandro
efb43cf7-b1dd-4994-87de-940cd088a7f5
Gerussi, Valentina
da4305b9-fcb1-40c1-8686-bde0de306df2
Visentini, Daniela
5069fe9e-c821-4435-b74e-cee64c8794c3
De Stefanis, Paola
9b21dbf9-7d6e-4e14-9fac-93a86a3bb845
Merelli, Maria
a4812708-5511-43bd-ab1e-f9118fa477d8
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Curcio, Francesco
d76c4146-ca25-41cb-9212-5b9fa91912f6
Sozio, Emanuela
d51c79ea-9349-45a0-8bd5-5fe4fd38265f
Tascini, Carlo
3178f7ca-5c39-408c-ad5d-5cb7164f987a
Fabris, Martina
ad0cf734-f7a0-472f-927e-f26b44837bee
D’Aurizio, Federica
a3a499c6-7210-4089-9f5f-67fffc2067bd
De Carlo, Chiara
57b9d9aa-1306-4d52-ace6-7b20f01b944f
Graziano, Elena
730410b8-36ba-4745-b0df-66922d355be7
Bassi, Flavio
0af5c47b-f768-4cda-9167-0fc2fc4677f7
Sbrana, Francesco
d795993c-5790-4ba2-bfaf-09496c8b23e0
Ripoli, Andrea
7c0ac6ca-31d2-4561-a708-418850bb708e
Pagotto, Alberto
4fdf47ba-7e8a-4882-982c-4b8d9fc46e16
Giacinta, Alessandro
efb43cf7-b1dd-4994-87de-940cd088a7f5
Gerussi, Valentina
da4305b9-fcb1-40c1-8686-bde0de306df2
Visentini, Daniela
5069fe9e-c821-4435-b74e-cee64c8794c3
De Stefanis, Paola
9b21dbf9-7d6e-4e14-9fac-93a86a3bb845
Merelli, Maria
a4812708-5511-43bd-ab1e-f9118fa477d8
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Curcio, Francesco
d76c4146-ca25-41cb-9212-5b9fa91912f6

Sozio, Emanuela, Tascini, Carlo, Fabris, Martina, D’Aurizio, Federica, De Carlo, Chiara, Graziano, Elena, Bassi, Flavio, Sbrana, Francesco, Ripoli, Andrea, Pagotto, Alberto, Giacinta, Alessandro, Gerussi, Valentina, Visentini, Daniela, De Stefanis, Paola, Merelli, Maria, Saeed, Kordo and Curcio, Francesco (2021) MR-proADM as prognostic factor of outcome in COVID-19 patients. Scientific Reports, 11 (1), [5121]. (doi:10.1038/s41598-021-84478-1).

Record type: Article

Abstract

Mid Regional pro-ADM (MR-proADM) is a promising novel biomarker in the evaluation of deteriorating patients and an emergent prognosis factor in patients with sepsis, septic shock and organ failure. It can be induced by bacteria, fungi or viruses. We hypothesized that the assessment of MR-proADM, with or without other inflammatory cytokines, as part of a clinical assessment of COVID-19 patients at hospital admission, may assist in identifying those likely to develop severe disease. A pragmatic retrospective analysis was performed on a complete data set from 111 patients admitted to Udine University Hospital, in northern Italy, from 25th March to 15th May 2020, affected by SARS-CoV-2 pneumonia. Clinical scoring systems (SOFA score, WHO disease severity class, SIMEU clinical phenotype), cytokines (IL-6, IL-1b, IL-8, TNF-α), and MR-proADM were measured. Demographic, clinical and outcome data were collected for analysis. At multivariate analysis, high MR-proADM levels were significantly associated with negative outcome (death or orotracheal intubation, IOT), with an odds ratio of 4.284 [1.893–11.413], together with increased neutrophil count (OR = 1.029 [1.011–1.049]) and WHO disease severity class (OR = 7.632 [5.871–19.496]). AUROC analysis showed a good discriminative performance of MR-proADM (AUROC: 0.849 [95% Cl 0.771–0.730]; p < 0.0001). The optimal value of MR-proADM to discriminate combined event of death or IOT is 0.895 nmol/l, with a sensitivity of 0.857 [95% Cl 0.728–0.987] and a specificity of 0.687 [95% Cl 0.587–0.787]. This study shows an association between MR-proADM levels and the severity of COVID-19. The assessment of MR-proADM combined with clinical scoring systems could be of great value in triaging, evaluating possible escalation of therapies, and admission avoidance or inclusion into trials. Larger prospective and controlled studies are needed to confirm these findings.

This record has no associated files available for download.

More information

Published date: 4 March 2021
Additional Information: Funding Information: No financial support was received. Publisher Copyright: © 2021, The Author(s).
Keywords: Adrenomedullin/blood, Aged, Biomarkers/blood, COVID-19/blood, Female, Humans, Male, Middle Aged, Peptide Fragments/blood, Prognosis, Protein Precursors/blood, Retrospective Studies

Identifiers

Local EPrints ID: 449164
URI: http://eprints.soton.ac.uk/id/eprint/449164
ISSN: 2045-2322
PURE UUID: ee0d36e9-3296-45cc-ba3b-dc4c80e82dd5
ORCID for Kordo Saeed: ORCID iD orcid.org/0000-0003-0123-0302

Catalogue record

Date deposited: 18 May 2021 16:33
Last modified: 18 Mar 2024 03:52

Export record

Altmetrics

Contributors

Author: Emanuela Sozio
Author: Carlo Tascini
Author: Martina Fabris
Author: Federica D’Aurizio
Author: Chiara De Carlo
Author: Elena Graziano
Author: Flavio Bassi
Author: Francesco Sbrana
Author: Andrea Ripoli
Author: Alberto Pagotto
Author: Alessandro Giacinta
Author: Valentina Gerussi
Author: Daniela Visentini
Author: Paola De Stefanis
Author: Maria Merelli
Author: Kordo Saeed ORCID iD
Author: Francesco Curcio

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×