The informative value of proadrenomedullin in patients with severe COVID-19

Malinina, D. A.; Шлык, И. В.; Polushin, Yu. S.; Afanasiev, Anton; Stanevich, Oksana V.; Bakin, Evgeny

doi:10.21292/2078-5658-2020-17-6-31-38

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Four papers were then excluded because they did not match the inclusion criteria. After an additional literature check, three papers were included in the systematic review [ 13 , 14 , 15 ]. A total of 20 articles were submitted to the systematic review.…”

Section: Resultsmentioning

confidence: 99%

“…Only 4 studied satisfied meta-analysis inclusion criteria. The reasons for exclusion of the 17 papers were: 12 papers did not consider ICU population, 2 papers evaluated different outcomes (i.e., renal replacement therapy, superinfections) [ 15 , 16 ], 1 analyzed MR-proADM levels among children versus adults patients [ 17 ], 1 considered pro-ADM levels with a different technique (bioactive ADM) [ 18 ], and 1 was excluded because it presented a population already included in a previously published study [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…The reviewed studies focused on two different populations, represented by ED and ICU patients. Among them, different outcomes were considered, sometimes compromising inter-study comparability (i.e., the use of RRT [ 16 ], superinfections [ 15 ], children versus adult population [ 17 ]).…”

Section: Discussionmentioning

confidence: 99%

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Proadrenomedullin in the Management of COVID-19 Critically Ill Patients in Intensive Care Unit: A Systematic Review and Meta-Analysis of Evidence and Uncertainties in Existing Literature

Montrucchio

Balzani

Lombardo

et al. 2022

JCM

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Mid-regional proadrenomedullin (MR-proADM) is a new biomarker of endothelial damage and its clinical use is increasing in sepsis and respiratory infections and recently in SARS-CoV-2 infection. We conducted a systematic review and meta-analysis to clarify the use of MR-proADM in severe COVID-19 disease. After Pubmed, Embase, and Scopus search, registries, and gray literature, deduplication, and selection of full-texts, we found 21 studies addressing the use of proadrenomedullin in COVID-19. All the studies were published between 2020 and 2022 from European countries. A total of 9 studies enrolled Intensive Care Unit (ICU) patients, 4 were conducted in the Emergency Department, and 8 had mixed populations. Regarding the ICU critically ill patients, 4 studies evaluating survival as primary outcome were available, of which 3 reported completed data. Combining the selected studies in a meta-analysis, a total of 252 patients were enrolled; of these, 182 were survivors and 70 were non-survivors. At the admission to the ICU, the average MR-proADM level in survivor patients was 1.01 versus 1.64 in non-survivor patients. The mean differences of MR-proADM values in survivors vs. non-survivors was −0.96 (95% CI from −1.26, to −0.65). Test for overall effect: Z = 6.19 (p < 0.00001) and heterogeneity was I2 = 0%. MR-proADM ICU admission levels seem to predict mortality among the critical COVID-19 population. Further, prospective studies, focused on critically ill patients and investigating a reliable MR-proADM cut-off, are needed to provide adequate guidance to its use in severe COVID-19.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Proadrenomedullin in the Management of COVID-19 Critically Ill Patients in Intensive Care Unit: A Systematic Review and Meta-Analysis of Evidence and Uncertainties in Existing Literature

Montrucchio

Balzani

Lombardo

et al. 2022

JCM

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Critical and non-critical coronavirus disease 2019 patients: which is the most predictive biomarker for disease severity and outcome?

Montrucchio,

Balzani,

Sales

et al. 2023

European Journal of Anaesthesiology Intensive Care

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BACKGROUND Severe acute respiratory syndrome-coronavirus-2 in coronavirus disease 2019 (COVID-19) patients leads to a wide range of clinical manifestations. The evaluation of mid-regional pro-adrenomedullin (MR-proADM) as a prognostic biomarker in noncritical wards (NON-ICU) and intensive care units (ICU), may have a potential in predicting disease severity and outcomes. OBJECTIVE To assess the difference in the prognostic power of MR-proADM in NON-ICU wards and in ICUs in a prospective multicentre cohort study. DESIGN From January to July 2021, all adult COVID-19 patients requiring admission for more than 48 h. SETTING One primary centre and two secondary centre hospitals. PATIENTS One hundred and twenty-three ICU and 77 NON-ICU patients. INTERVENTION MR-proADM, lymphocyte subpopulations and immunoglobulins were measured within 48 h and on days 3 and 7. A Log-rank test was used to compare survival curves, using a MR-proADM cut-off value of 1.5 nmol l−1. The predictive ability for mortality was compared using the area under the curve and 95% confidence interval (CI) of different receiver-operating characteristic curves. MAIN OUTCOME MEASURES The first 48 h MR-proADM values were significantly higher in the ICU group (median value 1.10 [IQR, 0.80 to 1.73] pg ml−1 vs. 0.90 [0.70 to 1.20] pg ml−1, P = 0.020), and statistically significant changes were observed over time for MR-proADM, CD3+, CD4+ and CD56+. In univariate analysis, MR-proADM was the only biomarker that significantly predicted mortality (P = 0.006). The logistic regression model showed an odds ratio for mortality equal to 1.83 (95% CI, 1.08 to 3.37) P = 0.035 for MR-proADM, 1.37 (1.15 to 1.68) P = 0.001 for MuLBSTA and 1.11 (1.05 to 1.18) P less than 0.001 for SAPS II. CONCLUSION MR-proADM admission values and trends over time appear to be a suitable marker of illness severity and a patient's risk of mortality in both ICU and NON-ICU settings. Lymphocyte subpopulation dysfunction seems to play a role in defining the severity of COVID-19 but is limited to ICU setting. TRIAL REGISTRATION on clinicaltrials.gov, NCT04873388 registered on March 2020.

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Use of exogenic phosphocreatine in ICU rehabilitation of patients with COVID-19 (pilot study)

Krapivina

Voevodin

Черняк

et al. 2021

Vestn. anesteziol. reanimatol.

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The objective: to establish the possible effectiveness of exogenous phosphocreatine as a component of pharmacological support during the resuscitation stage of rehabilitation measures in critically ill patients with COVID-19.Subjects and Methods. Within a randomized study, 21 patients diagnosed with COVID-19 were divided into two groups: Group 1 (patients received the infusion of exogenous phosphocreatine as part of intensive care) and Group 2 (patients received standard intensive care) against the background of rehabilitation measures. Patients were assessed for muscle strength using the MRC scale, exercise tolerance by Borg rating, oxygenation parameters, routine clinical laboratory blood tests, dependence on respiratory support, outcome on day 10 of therapy, and hospital outcome.Results. The effectiveness of the use of the exogenous phosphocreatine as a component of pharmacological support during the resuscitation stage of rehabilitation measures in critical patients has been confirmed by positive dynamics: an increase in muscle strength (the MRC score in the group receiving exogenous phosphocreatine on day 10 was 0.5 points higher) and an increase in exercise tolerance (Borg rating in the group receiving exogenous phosphocreatine on day 10 was 1.5 points higher), significant increase in oxygenation based on arterial blood saturation data, and significant increase in lymphocyte count by 25% in the group receiving exogenous phosphocreatine.Conclusion. Exogenous phosphocreatine is a candidate drug for pharmacological support during resuscitation stage of rehabilitation of critical patients with COVID-19.

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The informative value of proadrenomedullin in patients with severe COVID-19

Cited by 5 publications

References 22 publications

Proadrenomedullin in the Management of COVID-19 Critically Ill Patients in Intensive Care Unit: A Systematic Review and Meta-Analysis of Evidence and Uncertainties in Existing Literature

Proadrenomedullin in the Management of COVID-19 Critically Ill Patients in Intensive Care Unit: A Systematic Review and Meta-Analysis of Evidence and Uncertainties in Existing Literature

Critical and non-critical coronavirus disease 2019 patients: which is the most predictive biomarker for disease severity and outcome?

Use of exogenic phosphocreatine in ICU rehabilitation of patients with COVID-19 (pilot study)

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