Mortality in critically ill coronavirus disease 2019 (COVID-19) patients is high and pharmacological treatment strategies remain limited. Early-stage predictive biomarkers are needed to identify patients with a high risk of severe clinical courses and to stratify treatment strategies. Macrophage migration inhibitory factor (MIF) was previously described as a potential predictor for the outcome of critically ill patients and for acute respiratory distress syndrome (ARDS), a hallmark of severe COVID-19 disease. This prospective observational study evaluates the predictive potential of MIF for the clinical outcome after severe COVID-19 infection. Plasma MIF concentrations were measured in 36 mechanically ventilated COVID-19 patients over three days after intensive care unit (ICU) admission. Increased compared to decreased MIF was significantly associated with aggravated organ function and a significantly lower 28-day survival (sequential organ failure assessment (SOFA) score; 8.2 ± 4.5 to 14.3 ± 3, p = 0.009 vs. 8.9 ± 1.9 to 12 ± 2, p = 0.296; survival: 56% vs. 93%; p = 0.003). Arterial hypertension was the predominant comorbidity in 85% of patients with increasing MIF concentrations (vs. decreasing MIF: 39%; p = 0.015). Without reaching significance, more patients with decreasing MIF were able to improve their ARDS status ( p = 0.142). The identified association between an early MIF response, aggravation of organ function and 28-day survival may open future perspectives for biomarker-based diagnostic approaches for ICU management of COVID-19 patients.
【저자키워드】 COVID-19, acute respiratory distress syndrome (ARDS), SOFA score, ICU treatment, Macrophage Migration Inhibitory Factor (MIF), Horowitz Quotient, 【초록키워드】 coronavirus disease, ARDS, Biomarker, intensive care, prospective observational study, diagnostic, Comorbidity, outcome, hypertension, ICU, Clinical outcome, Clinical course, Migration, survival, Critically ill, management, Patient, SOFA, Admission, severe COVID-19 disease, COVID-19 patients, association, acute respiratory distress, Concentration, COVID-19 patient, Organ failure, pharmacological treatment, high risk, Predictive, Critically ill patient, Severe COVID-19 Infection, Treatment strategies, Perspective, syndrome, mechanically ventilated, hallmark, organ function, significantly lower, inhibitory, arterial, approach, IMPROVE, described, identify, evaluate, significantly, predominant, Increased, were measured, MIF, 【제목키워드】 Prospective, Factor, Ill, MIF,