Abstract
Purpose: We assessed the ability of mid-regional proadrenomedullin (MR-proADM) and C-terminal proendothelin-1 (CT-proET-1) to predict 28-day mortality in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.
Methods: Biomarkers were collected during the first seven days in this prospective observational cohort study. We investigated the relationship between biomarkers and mortality in a multivariable Cox regression model adjusted for age and SOFA score.
Results: In 105 critically ill patients with confirmed SARS-CoV-2 pneumonia 28-day mortality was 28.6%. MR-proADM and CT-proET-1 were significantly higher in 28-day non-survivors at baseline and over time. ROC curves revealed high accuracy to identify non-survivors for baseline MR-proADM and CT-proET-1, AUC 0.84, (95% CI 0.76-0.92), p < 0.001 and 0.79, (95% CI 0.69-0.89), p < 0.001, respectively. The AUC for prediction of 28-day mortality for MR-proADM and CT-proET-1 remained high over time. MR-proADM ≥1.57 nmol/L and CT-proET-1 ≥ 111 pmol/L at baseline were significant predictors for 28-day mortality (HR 6.80, 95% CI 3.12-14.84, p < 0.001 and HR 3.72, 95% CI 1.71-8.08, p 0.01).
Conclusion: Baseline and serial MR-proADM and CT-proET-1 had good ability to predict 28-day mortality in critically ill patients with SARS-CoV-2 pneumonia.
Trial registration: NEDERLANDS TRIAL REGISTER, NL8460.
Keywords: COVID-19; CT-proET-1; Critically ill; MR-proADM.
【저자키워드】 COVID-19, Critically ill, CT-proET-1, MR-proADM., 【초록키워드】 severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, coronavirus, Biomarker, Biomarkers, Mortality, Pneumonia, 28-day mortality, severe acute respiratory syndrome Coronavirus, Critically ill, age, predictor, SARS-CoV-2 pneumonia, respiratory, predict, critically ill patients, MR-proADM, ROC Curve, AUC, SOFA score, Critically ill patient, acute respiratory syndrome, 95% CI, acute respiratory syndrome coronavirus, ROC curves, multivariable Cox regression, high accuracy, non-survivor, multivariable Cox regression model, Seven, identify, collected, investigated, remained, adjusted, significantly higher, C-terminal, baseline, prospective observational cohort, 【제목키워드】 SARS-CoV-2, Biomarker, prospective cohort study, predict, Critically ill patient, C-terminal,