Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients

Abstract COVID-19 is a disease with a variable clinical course ranging from mild symptoms to critical illness, organ failure, and death. Prospective biomarkers may help to predict the severity of an individual’s clinical course and mortality risk. We analyzed asymmetric (ADMA) and symmetric dimethyl...

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Autores principales:	Juliane Hannemann, Paul Balfanz, Edzard Schwedhelm, Bojan Hartmann, Johanna Ule, Dirk Müller-Wieland, Edgar Dahl, Michael Dreher, Nikolaus Marx, Rainer Böger
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/cfb59b384f1342008b85e1afe0614aec
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spelling	oai:doaj.org-article:cfb59b384f1342008b85e1afe0614aec2021-12-02T16:57:57ZElevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients10.1038/s41598-021-89180-w2045-2322https://doaj.org/article/cfb59b384f1342008b85e1afe0614aec2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89180-whttps://doaj.org/toc/2045-2322Abstract COVID-19 is a disease with a variable clinical course ranging from mild symptoms to critical illness, organ failure, and death. Prospective biomarkers may help to predict the severity of an individual’s clinical course and mortality risk. We analyzed asymmetric (ADMA) and symmetric dimethylarginine (SDMA) in blood samples from 31 patients hospitalized for COVID-19. We calculated associations of ADMA and SDMA with mortality and organ failure, and we developed a predictive algorithm based upon these biomarkers to predict mortality risk. Nine patients (29%) experienced in-hospital death. SDMA and ADMA serum concentrations were significantly higher at admission in COVID-19 patients who died than in survivors. Cut-offs of 0.90 µmol/L for SDMA (AUC, 0.904, p = 0.0005) and 0.66 µmol/L for ADMA (AUC, 0.874, p = 0.0013) were found in ROC analyses to best discriminate both subgroups of patients. Hazard ratio for in-hospital mortality was 12.2 (95% CI: 2.2–31.2) for SDMA and 6.3 (1.1–14.7) for ADMA above cut-off. Sequential analysis of both biomarkers allowed discriminating a high-risk group (87.5% mortality) from an intermediate-risk group (25% mortality) and a low-risk group (0% mortality). Elevated circulating concentrations of SDMA and ADMA may help to better identify COVID-19 patients with a high risk of in-hospital mortality.Juliane HannemannPaul BalfanzEdzard SchwedhelmBojan HartmannJohanna UleDirk Müller-WielandEdgar DahlMichael DreherNikolaus MarxRainer BögerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juliane Hannemann Paul Balfanz Edzard Schwedhelm Bojan Hartmann Johanna Ule Dirk Müller-Wieland Edgar Dahl Michael Dreher Nikolaus Marx Rainer Böger Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
description	Abstract COVID-19 is a disease with a variable clinical course ranging from mild symptoms to critical illness, organ failure, and death. Prospective biomarkers may help to predict the severity of an individual’s clinical course and mortality risk. We analyzed asymmetric (ADMA) and symmetric dimethylarginine (SDMA) in blood samples from 31 patients hospitalized for COVID-19. We calculated associations of ADMA and SDMA with mortality and organ failure, and we developed a predictive algorithm based upon these biomarkers to predict mortality risk. Nine patients (29%) experienced in-hospital death. SDMA and ADMA serum concentrations were significantly higher at admission in COVID-19 patients who died than in survivors. Cut-offs of 0.90 µmol/L for SDMA (AUC, 0.904, p = 0.0005) and 0.66 µmol/L for ADMA (AUC, 0.874, p = 0.0013) were found in ROC analyses to best discriminate both subgroups of patients. Hazard ratio for in-hospital mortality was 12.2 (95% CI: 2.2–31.2) for SDMA and 6.3 (1.1–14.7) for ADMA above cut-off. Sequential analysis of both biomarkers allowed discriminating a high-risk group (87.5% mortality) from an intermediate-risk group (25% mortality) and a low-risk group (0% mortality). Elevated circulating concentrations of SDMA and ADMA may help to better identify COVID-19 patients with a high risk of in-hospital mortality.
format	article
author	Juliane Hannemann Paul Balfanz Edzard Schwedhelm Bojan Hartmann Johanna Ule Dirk Müller-Wieland Edgar Dahl Michael Dreher Nikolaus Marx Rainer Böger
author_facet	Juliane Hannemann Paul Balfanz Edzard Schwedhelm Bojan Hartmann Johanna Ule Dirk Müller-Wieland Edgar Dahl Michael Dreher Nikolaus Marx Rainer Böger
author_sort	Juliane Hannemann
title	Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
title_short	Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
title_full	Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
title_fullStr	Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
title_full_unstemmed	Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
title_sort	elevated serum sdma and adma at hospital admission predict in-hospital mortality of covid-19 patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/cfb59b384f1342008b85e1afe0614aec
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Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients

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