Role of MR-proADM and Monocyte CD169 in Predicting In-Hospital and 60-Day Mortality in COVID-19 Patients

Area of Science:

• Biomarkers and Diagnostics
• Infectious Diseases
• Critical Care Medicine

Background:

• Severe COVID-19 poses significant mortality risks, necessitating accurate prognostic indicators.
• Mid-regional pro-adrenomedullin (MR-proADM) and monocyte CD169 (CD169) have emerged as potential prognostic markers.
• Early identification of high-risk COVID-19 patients is crucial for timely intervention and resource allocation.

Purpose of the Study:

• To evaluate the predictive capability of MR-proADM and CD169 measurements upon emergency department (ED) admission.
• To forecast both in-hospital and 60-day mortality in adult COVID-19 patients.
• To analyze the association of these biomarkers with clinical and laboratory variables.

Main Methods:

• Retrospective analysis of clinical and laboratory data from 382 adult COVID-19 patients over 14 months.
• In-hospital mortality was the primary endpoint; 60-day mortality was the secondary endpoint.
• Univariate and multivariate analyses were performed to examine associations with mortality predictors.

Main Results:

• Significant predictors for in-hospital mortality included age ≥70 years, CD169 ratio ≥20, MR-proADM ≥1.1 mmol/L, invasive mechanical ventilation, and active cancer.
• Elevated MR-proADM levels (≥1.1 mmol/L) were strong predictors of in-hospital mortality (HR: 5.1).
• For 60-day mortality, elevated MR-proADM predicted increased risk (HR: 6.7), while a high serologic titer showed a protective effect (HR: 0.4).

Conclusions:

• A single measurement of MR-proADM and CD169 at ED admission provides prognostic value for in-hospital mortality in COVID-19 patients.
• MR-proADM levels are also predictive of 60-day mortality, highlighting its role in long-term outcomes.
• These biomarkers can aid in risk stratification and management of severe COVID-19 cases.