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Mid-Regional Pro-Adrenomedullin as a Prognostic Factor for Severe COVID-19 ARDS

Etienne de Montmollin1,2, Katell Peoc'h3,4, Mehdi Marzouk2

  • 1Université de Paris Cité, INSERM, UMR 1137, IAME, 75018 Paris, France.

Antibiotics (Basel, Switzerland)
|September 23, 2022
PubMed

Insights

Mid-regional proadrenomedullin (MR-proADM) effectively predicts mortality and bacterial superinfections in severe COVID-19 patients. Higher MR-proADM levels indicate a poorer prognosis and aid in identifying secondary infections.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Biomarker Research

Background:

  • Endothelial dysfunction is a key factor in severe SARS-CoV-2 infection.
  • Mid-regional proadrenomedullin (MR-proADM) is known to protect against endothelial permeability and predict outcomes in bacterial sepsis.

Purpose of the Study:

  • To evaluate MR-proADM as a prognostic biomarker for mortality in severe COVID-19.
  • To assess MR-proADM's utility in detecting bacterial superinfections in COVID-19 patients.

Main Methods:

  • Prospective inclusion of 135 ICU patients with severe SARS-CoV-2 pneumonia.
  • Serum MR-proADM levels measured on days 1, 3, and 7 post-admission.
  • Comparison of MR-proADM with procalcitonin and other inflammatory markers (CRP, LDH, lymphocytes).

Main Results:

  • MR-proADM levels were significantly higher in non-survivors at day 60.
  • Day-1 MR-proADM showed favorable prognostic performance (AUC 0.744) compared to procalcitonin (AUC 0.691).
  • Elevated MR-proADM levels correlated with respiratory and bloodstream bacterial superinfections.

Conclusions:

  • MR-proADM is a valuable predictor of outcome in severe COVID-19.
  • Serial MR-proADM measurements can provide additional prognostic information.
  • MR-proADM may serve as a useful biomarker for bacterial superinfection in COVID-19.
Keywords:
ARDSCOVID-19Mid-regional Pro-adrenomedullinSARS-CoV-2biomarkerprognosissuperinfection

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