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Identification of COVID-19 patients at risk of hospital admission and mortality: a European multicentre retrospective analysis of mid-regional pro-adrenomedullin

Identification of COVID-19 patients at risk of hospital admission and mortality: a European multicentre retrospective analysis of mid-regional pro-adrenomedullin

Authors :
Emanuela Sozio
Nathan A. Moore
Martina Fabris
Andrea Ripoli
Francesca Rumbolo
Marilena Minieri
Riccardo Boverio
María Dolores Rodríguez Mulero
Sara Lainez-Martinez
Mónica Martínez Martínez
Dolores Calvo
Claudia Gregoriano
Rebecca Williams
Luca Brazzi
Alessandro Terrinoni
Tiziana Callegari
Marta Hernández Olivo
Patricia Esteban-Torrella
Ismael Calcerrada
Luca Bernasconi
Stephen P. Kidd
Francesco Sbrana
Iria Miguens
Kirsty Gordon
Daniela Visentini
Jacopo M. Legramante
Flavio Bassi
Nicholas Cortes
Giorgia Montrucchio
Vito N. Di Lecce
Ernesto C. Lauritano
Luis García de Guadiana-Romualdo
Juan González del Castillo
Enrique Bernal-Morell
David Andaluz-Ojeda
Philipp Schuetz
Francesco Curcio
Carlo Tascini
Kordo Saeed
Source :
Respiratory Research, Vol 23, Iss 1, Pp 1-12 (2022)
Publication Year :
2022
Publisher :
BMC, 2022.

Abstract

Abstract Background Mid-Regional pro-Adrenomedullin (MR-proADM) is an inflammatory biomarker that improves the prognostic assessment of patients with sepsis, septic shock and organ failure. Previous studies of MR-proADM have primarily focussed on bacterial infections. A limited number of small and monocentric studies have examined MR-proADM as a prognostic factor in patients infected with SARS-CoV-2, however there is need for multicenter validation. An evaluation of its utility in predicting need for hospitalisation in viral infections was also performed. Methods An observational retrospective analysis of 1861 patients, with SARS-CoV-2 confirmed by RT-qPCR, from 10 hospitals across Europe was performed. Biomarkers, taken upon presentation to Emergency Departments (ED), clinical scores, patient demographics and outcomes were collected. Multiclass random forest classifier models were generated as well as calculation of area under the curve analysis. The primary endpoint was hospital admission with and without death. Results Patients suitable for safe discharge from Emergency Departments could be identified through an MR-proADM value of ≤ 1.02 nmol/L in combination with a CRP (C-Reactive Protein) of ≤ 20.2 mg/L and age ≤ 64, or in combination with a SOFA (Sequential Organ Failure Assessment) score 0.85 nmol/L, in combination with a SOFA score ≥ 2 and LDH > 720 U/L, or in combination with a CRP > 29.26 mg/L and age ≤ 64, when MR-proADM was > 1.02 nmol/L. Conclusions This international study suggests that for patients presenting to the ED with confirmed SARS-CoV-2 infection, MR-proADM in combination with age and CRP or with the patient’s SOFA score could identify patients at low risk where outpatient treatment may be safe.

Details

Language :
English
ISSN :
1465993X
Volume :
23
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Respiratory Research
Publication Type :
Academic Journal
Accession number :
edsdoj.f5832d2b581a4a169f76c74dbc7a4499
Document Type :
article
Full Text :
https://doi.org/10.1186/s12931-022-02151-1