Effectiveness of mid-regional pro-adrenomedullin (MR-proADM) as prognostic marker in COVID-19 critically ill patients: An observational prospective study.
Giorgia Montrucchio,Gabriele Sales,Francesca Rumbolo,Filippo Palmesino,Vito Fanelli,Rosario Urbino,Claudia Filippini,Giulio Mengozzi,Luca Brazzi +8 more
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TLDR
In this paper, the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting mortality in COVID-19-ICU-patients was evaluated.Abstract:
OBJECTIVE: To test the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting mortality in COVID-19-ICU-patients. METHODS: All consecutive COVID-19 adult patients admitted between March and June 2020 to the ICU of a referral, university hospital in Northern-Italy were enrolled. MR-proADM and routine laboratory test were measured within 48 hours from ICU admission, on day 3, 7 and 14. Survival curves difference with MR-proADM cut-off set to 1.8 nmol/L were tested using log-rank test. Predictive ability was compared using area under the curve and 95% confidence interval of different receiver-operating characteristics curves. RESULTS: 57 patients were enrolled. ICU and overall mortality were 54.4%. At admission, lymphocytopenia was present in 86% of patients; increased D-dimer and CRP levels were found in 84.2% and 87.7% of patients respectively, while PCT values > 0.5 µg/L were observed in 47.4% of patients. MR-proADM, CRP and LDH were significantly different between surviving and non-surviving patients and over time, while PCT, D-dimer and NT-pro-BNP did not show any difference between the groups and over time; lymphocytes were different between surviving and non-surviving patients only. MR-proADM was higher in dying patients (2.65±2.33vs1.18±0.47, p 1.8 nmol/L (p = 0.016). The logistic regression model adjusted for age, gender, cardiovascular disease, diabetes mellitus and PCT values confirmed an odds ratio = 10.3 [95%CI:1.9-53.6] (p = 0.006) for MR-proADM >1.8 nmol/L and = 22.2 [95%CI:1.6-316.9] (p = 0.022) for cardiovascular disease. Overall, MR-proADM had the best predictive ability (AUC = 0.85 [95%CI:0.78-0.90]). CONCLUSIONS: In COVID-19 ICU-patients, MR-proADM seems to have constantly higher values in non-survivor patients and predict mortality more precisely than other biomarkers. Repeated MR-proADM measurement may support a rapid and effective decision-making. Further studies are needed to better explain the mechanisms responsible of the increase in MR-proADM in COVID-19 patients.read more
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Coronavirus Disease 2019 as Cause of Viral Sepsis: A Systematic Review and Meta-Analysis.
Eleni Karakike,Evangelos J. Giamarellos-Bourboulis,Miltiades Kyprianou,Carolin Fleischmann-Struzek,Mathias W. Pletz,Mihai G. Netea,Konrad Reinhart,Evdoxia Kyriazopoulou +7 more
TL;DR: In this paper, the authors conducted a systematic review on the prevalence of coronavirus disease 2019-related sepsis among adults hospitalized in the ICU and the general ward.
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MR-proADM as prognostic factor of outcome in COVID-19 patients.
Emanuela Sozio,Carlo Tascini,Martina Fabris,Federica D'Aurizio,Chiara De Carlo,Elena Graziano,Flavio Bassi,Francesco Sbrana,Andrea Ripoli,Alberto Pagotto,Alessandro Giacinta,Valentina Gerussi,Daniela Visentini,Paola De Stefanis,Maria Merelli,Kordo Saeed,Francesco Curcio +16 more
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TL;DR: In this paper , the authors conducted an electronic search of PubMed, Scopus, Ovid, Willey, Web of Science, Cochrane library, and CNKI for studies reporting immunological and/or immune related parameters, including hematological, inflammatory, coagulation, and biochemical variables, tested on hospital admission of COVID-19 patients with different severities and outcomes.
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Circulating MR-proADM levels, as an indicator of endothelial dysfunction, for early risk stratification of mid-term mortality in COVID-19 patients.
Luis García de Guadiana-Romualdo,Monica Martinez,María Dolores Rodríguez Mulero,Patricia Esteban-Torrella,Marta Hernández Olivo,María José Alcaraz García,Valerio Campos-Rodríguez,Natalia Sancho-Rodríguez,María Galindo Martínez,Antonia Alcaraz,María Salomé Ros Braquehais,Carlos Báguena Perez-Crespo,Verónica Ramos Arenas,Cristina Tomás Jiménez,Luciano Consuegra-Sánchez,Andrés Conesa-Hernandez,Pascual Piñera-Salmerón,Enrique Bernal-Morell +17 more
TL;DR: In this article, the role of MR-proADM in the mid-term mortality in COVID-19 patients was evaluated and it was shown that MR-ProADM levels (inverse transformed), after adjusting by a propensity score including eleven potential confounders, were an independent predictor of 90-day mortality.
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Elevated Procalcitonin Is Positively Associated with the Severity of COVID-19: A Meta-Analysis Based on 10 Cohort Studies.
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TL;DR: The Surviving Sepsis Campaign CO VID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19, and will provide new recommendations in further releases of these guidelines.
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