MR-proADM as prognostic factor of outcome in COVID-19 patients
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-pr...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Nature Portfolio
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/a8a013a15cbd41c2a6ba4ba6f7e62b67 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:a8a013a15cbd41c2a6ba4ba6f7e62b67 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:a8a013a15cbd41c2a6ba4ba6f7e62b672021-12-02T13:34:50ZMR-proADM as prognostic factor of outcome in COVID-19 patients10.1038/s41598-021-84478-12045-2322https://doaj.org/article/a8a013a15cbd41c2a6ba4ba6f7e62b672021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84478-1https://doaj.org/toc/2045-2322Abstract 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.Emanuela SozioCarlo TasciniMartina FabrisFederica D’AurizioChiara De CarloElena GrazianoFlavio BassiFrancesco SbranaAndrea RipoliAlberto PagottoAlessandro GiacintaValentina GerussiDaniela VisentiniPaola De StefanisMaria MerelliKordo SaeedFrancesco CurcioNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q 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 MR-proADM as prognostic factor of outcome in COVID-19 patients |
| description |
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. |
| format |
article |
| author |
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 |
| author_facet |
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 |
| author_sort |
Emanuela Sozio |
| title |
MR-proADM as prognostic factor of outcome in COVID-19 patients |
| title_short |
MR-proADM as prognostic factor of outcome in COVID-19 patients |
| title_full |
MR-proADM as prognostic factor of outcome in COVID-19 patients |
| title_fullStr |
MR-proADM as prognostic factor of outcome in COVID-19 patients |
| title_full_unstemmed |
MR-proADM as prognostic factor of outcome in COVID-19 patients |
| title_sort |
mr-proadm as prognostic factor of outcome in covid-19 patients |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/a8a013a15cbd41c2a6ba4ba6f7e62b67 |
| work_keys_str_mv |
AT emanuelasozio mrproadmasprognosticfactorofoutcomeincovid19patients AT carlotascini mrproadmasprognosticfactorofoutcomeincovid19patients AT martinafabris mrproadmasprognosticfactorofoutcomeincovid19patients AT federicadaurizio mrproadmasprognosticfactorofoutcomeincovid19patients AT chiaradecarlo mrproadmasprognosticfactorofoutcomeincovid19patients AT elenagraziano mrproadmasprognosticfactorofoutcomeincovid19patients AT flaviobassi mrproadmasprognosticfactorofoutcomeincovid19patients AT francescosbrana mrproadmasprognosticfactorofoutcomeincovid19patients AT andrearipoli mrproadmasprognosticfactorofoutcomeincovid19patients AT albertopagotto mrproadmasprognosticfactorofoutcomeincovid19patients AT alessandrogiacinta mrproadmasprognosticfactorofoutcomeincovid19patients AT valentinagerussi mrproadmasprognosticfactorofoutcomeincovid19patients AT danielavisentini mrproadmasprognosticfactorofoutcomeincovid19patients AT paoladestefanis mrproadmasprognosticfactorofoutcomeincovid19patients AT mariamerelli mrproadmasprognosticfactorofoutcomeincovid19patients AT kordosaeed mrproadmasprognosticfactorofoutcomeincovid19patients AT francescocurcio mrproadmasprognosticfactorofoutcomeincovid19patients |
| _version_ |
1718392754752454656 |