The vasoactive peptide MR-pro-adrenomedullin in COVID-19 patients: an observational study

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.

Angaben zum Objekt

• Standort: Deutsche Nationalbibliothek Frankfurt am Main
• Umfang: Online-Ressource
• Sprache: Englisch

Verweise und Beziehungen

• Erschienen in: The vasoactive peptide MR-pro-adrenomedullin in COVID-19 patients: an observational study ; volume:59 ; number:5 ; year:2021 ; pages:995-1004 ; extent:10 ; Clinical chemistry and laboratory medicine ; 59, Heft 5 (2021), 995-1004 (gesamt 10)

Beteiligte, Orts- und Zeitangaben

• Urheber: Gregoriano, Claudia ; Koch, Daniel ; Kutz, Alexander ; Haubitz, Sebastian ; Conen, Anna ; Bernasconi, Luca ; Hammerer-Lercher, Angelika ; Saeed, Kordo ; Mueller, Beat ; Schuetz, Philipp

Weitere Informationen

• DOI: 10.1515/cclm-2020-1295
• URN: urn:nbn:de:101:1-2022052509044833560949
• Rechteinformation: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Letzte Aktualisierung: 15.08.2025, 07:28 MESZ