Prognostic value of copeptin and mid‐regional proadrenomedullin in COVID‐19‐hospitalized patients

Indirli, Rita; Valenti, Luca; Ceriotti, Ferruccio; Modugno, Adriana Di; Resi, Veronica; Orsi, Emanuela; Arosio, Maura; Mantovani, Giovanna; Ferrante, E.; Bosari, Silvano; Scudeller, Luigia; Fusetti, Giuliana; Rusconi, Laura; Dell’Orto, Silvia; Prati, Daniele; Valenti, L.; Giovannelli, Silvia; Gori, Andrea; Bandera, Alessandra; Muscatello, Antonio; Mangioni, Davide; Alagna, Laura; Bozzi, Giorgio; Lombardi, Andrea; Ungaro, Riccardo; Itri, Teresa; Ferroni, Valentina; Pastore, Valeria; Massafra, Roberta; Rondolini, Ilaria; Peyvandi, Flora; Gualtierotti, Roberta; Ferrari, Barbara; Rossio, Raffaella; Corona, E; Rampi, Nicolò; Massimo, Costanza; Montaño, Nixon Arboleda; Vigone, Barbara; Bellocchi, Chiara; Coti, Giulia; Sternativo, Mimma; Blasi, Francesco; Mantero, Marco; Spotti, M.; Simonetta, Edoardo; Terranova, Leonardo; Amati, Francesco; Miele, Carmen; Vigni, A.; Costantino, Giorgio; Solbiati, Monica; Furlan, Ludovico; Mancarella, Marta; Colombo, Giulia; Colombo, G; Monzani, Valter; Rovellini, A.; Billi, Filippo; Folli, Christian; Baldini, Marina; Motta, Irena; Lombardi, Rosa; Cesari, Matteo; Proietti, Marco; Nobili, Alessandro; Tettamanti, Mauro

doi:10.1111/eci.13753

Cited by 16 publications

(18 citation statements)

References 60 publications

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“…Fourteen studies were included in the meta-analysis, with a total of 2,384 patients. Of the above studies, ten are prospective observational studies [ 37 , 38 , 41–44 , 46–49 ], and four are retrospective observational studies [ 36 , 39 , 40 , 45 ]. Five of them were conducted in Italy [ 36 , 39–41 , 47 ], two in Spain [ 37 , 42 ], two in Russia [ 44 , 49 ], one in Switzerland [ 38 ], one in the Netherlands [ 43 ], one in USA [ 45 ], one in France [ 46 ] and one in United Kingdom [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta-analysis of mid-regional pro-adrenomedullin (MR-proadm) as a prognostic marker in Covid-19-hospitalized patients

Fialek

Roquetaillade

Pruc³

et al. 2023

Annals of Medicine

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Background Mid-regional pro-adrenomedullin (MR-proADM) is useful for risk stratification in patients with sepsis and respiratory infections. The study’s purpose was to assess the available data and determine the association between MR-proADM levels and mortality in COVID-19 participants. Methods A comprehensive literature search of medical electronic databases was performed including PubMed, Web of Science, Scopus, Cochrane, and grey literature for relevant data published from 1 January 2020, to 20 November 2022. Mean differences (MD) with 95% confidence intervals (CI) were calculated. Results Fourteen studies reported MR-proADM levels in survivors vs. non-survivors of COVID-19 patients. Pooled analysis showed that MR-proADM level in the survivor group was 0.841 ± 0.295 nmol/L for patients who survive COVID-19, compared to 1.692 ± 0.761 nmol/L for non-survivors (MD = −0.78; 95%CI: −0.92 to −0.64; p < 0.001). Conclusions The main finding of this study is that mortality of COVID-19 is linked to MR-proADM levels, according to this meta-analysis. The use of MR-proADM might be extremely beneficial in triaging, assessing probable therapy escalation, predicting potential complications during therapy or significant clinical deterioration of patients, and avoiding admission which may not be necessary. Nevertheless, in order to confirm the obtained data, it is necessary to conduct large prospective studies that will address the potential diagnostic role of MR-proADM as a marker of COVID-19 severity. KEY MESSAGES Severity of COVID-19 seems to be linked to MR-proADM levels and can be used as a potential marker for predicting a patient’s clinical course. The use of MR-proADM might be beneficial in triaging, assessing probable therapy escalation, predicting potential complications during therapy or significant clinical deterioration of patients, and avoiding admission which may not be necessary. For patients with COVID-19, MR-proADM may be an excellent prognostic indicator because it is a marker of endothelial function that may predict the precise impact on the equilibrium between vascular relaxation and contraction and lowers platelet aggregation inhibitors, coagulation inhibitors, and fibrinolysis activators in favor of clotting factors.

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Section: Resultsmentioning

confidence: 99%

Systematic review with meta-analysis of mid-regional pro-adrenomedullin (MR-proadm) as a prognostic marker in Covid-19-hospitalized patients

Fialek

Roquetaillade

Pruc³

et al. 2023

Annals of Medicine

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“…Thus, it appears that PASC‐CVS related severity of diminished flow‐mediated epicardial vasodilation is widely constant and likely sustained by a chronic immune‐modulatory and inflammatory response. 27 , 28 , 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

“…Of further interest, we did not observe an association between PASC‐CVS interval and PET‐determined impairment of flow‐mediated epicardial vasodilation. Thus, it appears that PASC‐CVS related severity of diminished flow‐mediated epicardial vasodilation is widely constant and likely sustained by a chronic immune‐modulatory and inflammatory response 27–30 …”

Section: Discussionmentioning

confidence: 99%

Post COVID‐19 syndrome with impairment of flow‐mediated epicardial vasodilation and flow reserve

Verma

Ramayya

Upadhyaya

et al. 2022

Eur J Clin Investigation

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Aims The aim of this study is to evaluate whether post‐acute sequelae of COVID‐19 cardiovascular syndrome (PASC‐CVS) is associated with alterations in coronary circulatory function. Materials and Methods In individuals with PASC‐CVS but without known cardiovascular risk factors ( n = 23) and in healthy controls (CON, n = 23), myocardial blood flow (MBF) was assessed with 13 N‐ammonia and PET/CT in mL/g/min during regadenoson‐stimulated hyperemia, at rest, and the global myocardial flow reserve (MFR) was calculated. MBF was also measured in the mid and mid‐distal myocardium of the left ventricle (LV). The Δ longitudinal MBF gradient (hyperemia minus rest) as a reflection of an impairment of flow‐mediated epicardial vasodilation, was calculated. Results Resting MBF was significantly higher in PASC‐CVS than in CON (1.29 ± 0.27 vs. 1.08 ± 0.20 ml/g/min, p ≤ .024), while hyperemic MBFs did not differ significantly among groups (2.46 ± 0.53 and 2.40 ± 0.34 ml/g/min, p = .621). The MFR was significantly less in PASC‐CVS than in CON (1.97 ± 0.54 vs. 2.27 ± 0.43, p ≤ .031). In addition, there was a Δ longitudinal MBF gradient in PASC‐CVS, not observed in CON (−0.17 ± 0.18 vs. 0.04 ± 0.11 ml/g/min, p < .0001). Conclusions Post‐acute sequelae of COVID‐19 cardiovascular syndrome may be associated with an impairment of flow‐mediated epicardial vasodilation, while reductions in coronary vasodilator capacity appear predominantly related to increases in resting flow in women deserving further investigations.

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“…In recent years, blood copeptin has been recognized as a reliable surrogate marker for severity of disease and adverse outcomes. In adults, it has been shown to predict adverse outcomes in ischemic [ 45 ] and hemorrhagic stroke [ 46 ], heart failure [ 47 ], community-acquired pneumonia [ 48 ], COVID-19 [ 49 ] and many more [ 50 , 51 , 52 ]. In children, copeptin predicted an adverse outcome in community-acquired pneumonia [ 25 , 26 ], congenital heart disease and pulmonary arterial hypertension [ 27 ], perinatal asphyxia [ 28 ], traumatic brain injury [ 31 ] and severity of disease, as well as mortality, in PICU [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

et al. 2022

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Low copeptin levels may indicate inadequate arginine-vasopressin release promoting arterial hypotension, whereas high copeptin concentrations may reflect disease severity. This single-center prospective non-randomized clinical trial analyzed the course of blood copeptin in critically ill normo- and hypotensive children and its association with disease severity. In 164 patients (median age 0.5 years (interquartile range 0.1, 2.9)), the mean copeptin concentration at baseline was 43.5 pmol/L. Though not significantly different after 61 h (primary outcome, mean individual change: −12%, p = 0.36, paired t-test), we detected 1.47-fold higher copeptin concentrations during arterial hypotension when compared to normotension (mixed-effect ANOVA, p = 0.01). In total, 8 out of 34 patients (23.5%) with low copeptin concentrations <10 pmol/L were hypotensive. Copeptin was highest in the adjusted mixed-effect regression analysis within the first day (+20% at 14 h) and decreased significantly at 108 h (−27%) compared to baseline (p = 0.002). Moreover, we found a significant association with vasopressor-inotrope treatment intensity, infancy (1–12 months) and cardiopulmonary bypass (all p ≤ 0.001). In conclusion, high copeptin values were associated with arterial hypotension and severity of disease in critically ill children. This study does not support the hypothesis that low copeptin values might be indicative of arginine-vasopressin deficiency.

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Prognostic value of copeptin and mid‐regional proadrenomedullin in COVID‐19‐hospitalized patients

Cited by 16 publications

References 60 publications

Systematic review with meta-analysis of mid-regional pro-adrenomedullin (MR-proadm) as a prognostic marker in Covid-19-hospitalized patients

Systematic review with meta-analysis of mid-regional pro-adrenomedullin (MR-proadm) as a prognostic marker in Covid-19-hospitalized patients

Post COVID‐19 syndrome with impairment of flow‐mediated epicardial vasodilation and flow reserve

Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

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