Proadrenomedullin levels and clinical features of SARS-CoV-2 coronavirus infection: a prospective clinical study


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Abstract

Background. According to current data, the development of endothelial dysfunction (ED) is one of the leading causes that determine the severity of the course and prognosis in patients with COVID-19. To date, there are several different biomarkers can be used in clinical practice to assess ED. One such marker is proadrenomedullin (pro-ADM). Objective. Evaluation of the dynamics of pro-ADM levels in patients with COVID-19 infection and determination of the correlation of pro-ADM level with the severity of the condition, as well as with other clinical diagnostic indicators. Methods. A prospective, single-center study included 140 consecutive patients over 18 years of age hospitalized with a diagnosis of novel coronavirus infection. Upon admission to the hospital, the MR-proADM level was determined on the 1st and 3rd days of hospitalization by enzyme immunoassay in addition to standard clinical and laboratory parameters in all patients. Results. Depending on the outcome of the disease, all patients included in the study were divided into two groups: those discharged with recovery or improvement (n=110) and those who died during their stay in the hospital (n=30). The deceased patients had a statistically significantly older age - 76 (63-93) years compared to 66 (62-67) years (P<0.0001), a higher NEWS score of 5 (3-8) points compared to 2 (0-6) points (P<0.0001), more severe lung damage according to computed tomography (CT) - grade 3 (2-4) compared to CT-1 (1-3) grade (P< 0.0001), a longer hospital stay of 17 (7-35) versus 6 (3-14) bed days (P<0.05), and a higher pro-ADM level of 1855.2 pmol/mL (1078.42596.5) compared to 270.7 (155.06-427.1) pmol/mL (P<0.0001). The correlation coefficient between the pro-ADM level and the severity of lung damage was rs=0.7 (P<0.0001). The correlation coefficient between the pro-ADM level and the NEWS score was rs=0.6 (P<0.0001). Conclusions. The pro-ADM level directly depends on the severity of the patient’s condition with COVID-19. High pro-ADM levels were characteristic of patients with more extensive lung tissue damage, as well as patients with higher NEWS scores, indicating a more severe ED, which determined the overall risk and prognosis of such patients.

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About the authors

A. A Astapovsky

M. Sechenov First Moscow State Medical University (Sechenov University)

Email: ai.astapovskii@gmail.com
Moscow, Russia

V. N Drozdov

M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

E. V Shikh

M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

N. B Lazareva

M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

G. G Melkonyan

Hospital for War Veterans № 3 of the Moscow Healthcare Department

Moscow, Russia

A. A Meshcheryakov

Hospital for War Veterans № 3 of the Moscow Healthcare Department

Moscow, Russia

E. V Tsepkova

City Clinical Hospital № 40 of the Moscow Healthcare Department

Moscow, Russia

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