tetano
Editor, Senior Moderator
Eur J Clin Invest
. 2022 Feb 7;e13753.
doi: 10.1111/eci.13753. Online ahead of print.
Prognostic value of copeptin and mid-regional proadrenomedullin in COVID-19-hospitalized patients
Rita Indirli[SUP] 1 2 [/SUP], Alessandra Bandera[SUP] 3 [/SUP], Luca Valenti[SUP] 4 [/SUP], Ferruccio Ceriotti[SUP] 5 [/SUP], Adriana Di Modugno[SUP] 5 [/SUP], Mauro Tettamanti[SUP] 6 [/SUP], Roberta Gualtierotti[SUP] 7 [/SUP], Flora Peyvandi[SUP] 7 [/SUP], Nicola Montano[SUP] 8 [/SUP], Francesco Blasi[SUP] 9 10 [/SUP], Giorgio Costantino[SUP] 11 [/SUP], Veronica Resi[SUP] 1 [/SUP], Emanuela Orsi[SUP] 1 [/SUP], Maura Arosio[SUP] 1 2 [/SUP], Giovanna Mantovani[SUP] 1 2 [/SUP], Emanuele Ferrante[SUP] 1 [/SUP], COVID-19 Network Working Group
Collaborators, Affiliations
Abstract
Background: Biomarkers are used for diagnosis, risk stratification and medical decisions. Copeptin and mid-regional proadrenomedullin (MR-proADM) are markers of stress and endothelial function, respectively, which have been studied in pneumonia, sepsis and septic shock. This study aimed to assess whether copeptin and MR-proADM could predict coronavirus disease 2019 (COVID-19) in-hospital outcomes, that is multi-system complications, length of stay and mortality.
Methods: Copeptin and MR-proADM were assessed at admission in 116 patients hospitalized with COVID-19. Data were retrospectively extracted from an online database. The primary endpoint was in-hospital mortality. The secondary endpoints were in-hospital complications, the composite outcome 'death, or admission to intensive care unit, or in-hospital complications', and length of stay. The predictive power was expressed as area under the receiver operator characteristic curve (AUROC).
Results: Copeptin was increased in non-survivors (median 29.7 [interquartile range 13.0-106.2] pmol/L) compared to survivors (10.9 [5.9-25.3] pmol/L, p < 0.01). The AUROC for mortality was 0.71, with a hazard ratio of 3.67 (p < 0.01) for copeptin values > 25.3 pmol/L. MR-proADM differentiated survivors (0.8 [0.6-1.1] nmol/L) from non-survivors (1.5 [1.1-2.8] nmol/L, p < 0.001) and yielded a AUROC of 0.79 and a hazard ratio of 7.02 (p < 0.001) for MR-proADM values > 1.0 nmol/L. Copeptin and MR-proADM predicted sepsis (AUROC 0.95 and 0.96 respectively), acute kidney injury (0.87 and 0.90), the composite outcome (0.69 and 0.75) and length of stay (r = 0.42, p < 0.001, and r = 0.46, p < 0.001).
Conclusions: Admission MR-proADM and copeptin may be implemented for early risk stratification in COVID-19-hospitalized patients to help identify those eligible for closer monitoring and care intensification.
Keywords: COVID-19; biomarkers; copeptin; mid-regional proadrenomedullin; mortality; prognosis.
. 2022 Feb 7;e13753.
doi: 10.1111/eci.13753. Online ahead of print.
Prognostic value of copeptin and mid-regional proadrenomedullin in COVID-19-hospitalized patients
Rita Indirli[SUP] 1 2 [/SUP], Alessandra Bandera[SUP] 3 [/SUP], Luca Valenti[SUP] 4 [/SUP], Ferruccio Ceriotti[SUP] 5 [/SUP], Adriana Di Modugno[SUP] 5 [/SUP], Mauro Tettamanti[SUP] 6 [/SUP], Roberta Gualtierotti[SUP] 7 [/SUP], Flora Peyvandi[SUP] 7 [/SUP], Nicola Montano[SUP] 8 [/SUP], Francesco Blasi[SUP] 9 10 [/SUP], Giorgio Costantino[SUP] 11 [/SUP], Veronica Resi[SUP] 1 [/SUP], Emanuela Orsi[SUP] 1 [/SUP], Maura Arosio[SUP] 1 2 [/SUP], Giovanna Mantovani[SUP] 1 2 [/SUP], Emanuele Ferrante[SUP] 1 [/SUP], COVID-19 Network Working Group
Collaborators, Affiliations
- PMID: 35128648
- DOI: 10.1111/eci.13753
Abstract
Background: Biomarkers are used for diagnosis, risk stratification and medical decisions. Copeptin and mid-regional proadrenomedullin (MR-proADM) are markers of stress and endothelial function, respectively, which have been studied in pneumonia, sepsis and septic shock. This study aimed to assess whether copeptin and MR-proADM could predict coronavirus disease 2019 (COVID-19) in-hospital outcomes, that is multi-system complications, length of stay and mortality.
Methods: Copeptin and MR-proADM were assessed at admission in 116 patients hospitalized with COVID-19. Data were retrospectively extracted from an online database. The primary endpoint was in-hospital mortality. The secondary endpoints were in-hospital complications, the composite outcome 'death, or admission to intensive care unit, or in-hospital complications', and length of stay. The predictive power was expressed as area under the receiver operator characteristic curve (AUROC).
Results: Copeptin was increased in non-survivors (median 29.7 [interquartile range 13.0-106.2] pmol/L) compared to survivors (10.9 [5.9-25.3] pmol/L, p < 0.01). The AUROC for mortality was 0.71, with a hazard ratio of 3.67 (p < 0.01) for copeptin values > 25.3 pmol/L. MR-proADM differentiated survivors (0.8 [0.6-1.1] nmol/L) from non-survivors (1.5 [1.1-2.8] nmol/L, p < 0.001) and yielded a AUROC of 0.79 and a hazard ratio of 7.02 (p < 0.001) for MR-proADM values > 1.0 nmol/L. Copeptin and MR-proADM predicted sepsis (AUROC 0.95 and 0.96 respectively), acute kidney injury (0.87 and 0.90), the composite outcome (0.69 and 0.75) and length of stay (r = 0.42, p < 0.001, and r = 0.46, p < 0.001).
Conclusions: Admission MR-proADM and copeptin may be implemented for early risk stratification in COVID-19-hospitalized patients to help identify those eligible for closer monitoring and care intensification.
Keywords: COVID-19; biomarkers; copeptin; mid-regional proadrenomedullin; mortality; prognosis.