Mid-regional Proadrenomedullin Biomarker Predicts Coronavirus Disease 2019 Clinical Outcomes: A US-Based Cohort Study. (24th August 2022)

• Record Type: Journal Article
• Authors: Atallah, Natalie J; Panossian, Vahe S; Atallah, Christine J; Schwabe, Andrej; Johannes, Sascha; Wiemer, Jan; Mansour, Michael K
• Is Part Of: Open forum infectious diseases. Volume 9:Number 9(2022)
• Publication Date: 2022-08-24
• Subjects: biomarkers -- COVID-19 -- ICU -- MR-proADM -- viral pneumonia; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac423
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Mid-regional proadrenomedullin (MR-proADM) is a biomarker released following endothelial damage. Studies have shown a correlation in predicting coronavirus disease 2019 (COVID-19) outcomes with MR-proADM levels. Our study aimed to investigate baseline MR-proADM as a predictor of a wider range of clinical outcomes of varying severity in patients admitted with COVID-19, and to compare to other biomarkers. Methods: Data from the Boston Area COVID-19 Consortium (BACC) Bay Tocilizumab Trial was used in this study. Patients with biomarker determinations, and not admitted to the intensive care unit (ICU) on admission, were included. MR-proADM cutoff of 0.87 nmol/L was assessed in predicting clinical outcomes. Results: Of 182 patients, 11.0% were mechanically ventilated or dead within 28 days. Of patients with MR-proADM >0.87 nmol/L, 21.1% were mechanically ventilated or dead within 28 days, compared with 4.5% of those with MR-proADM ≤0.87 nmol/L ( P < .001). The sensitivity, specificity, negative predictive value, and positive predictive value of MR-proADM cutoff of 0.87 nmol/L in predicting mechanical ventilation or death were 75%, 65%, 95%, and 21%, respectively, with an area under the receiver operating characteristic curve of 0.76. On multivariable logistic regression analysis, MR-proADM >0.87 nmol/L was independently associated with mechanical ventilation or death, ICU admission, prolonged hospitalization beyond day 4, and day 4 COVID-19 ordinal scale equal to or worse than day 1. Conclusions: MR-proADM functions as a valuable biomarker for the early risk stratification and detection of severe disease progression of patients with COVID-19. In the prediction of death, MR-proADM performed better compared to many other commonly used biomarkers. Abstract : Mid-regional proadrenomedullin (MR-proADM) is a novel biomarker that predicts COVID-19 clinical outcomes. In this first US-based cohort study on the role of MR-proADM in COVID-19, MR-proADM cutoff of 0.87 nmol/L was independently associated with prolonged hospitalization, mechanical ventilation, and death.