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Prognostic value of copeptin and mid‐regional proadrenomedullin in COVID‐19‐hospitalized patients
Author(s) -
Indirli Rita,
Bandera Alessandra,
Valenti Luca,
Ceriotti Ferruccio,
Di Modugno Adriana,
Tettamanti Mauro,
Gualtierotti Roberta,
Peyvandi Flora,
Montano Nicola,
Blasi Francesco,
Costantino Giorgio,
Resi Veronica,
Orsi Emanuela,
Arosio Maura,
Mantovani Giovanna,
Ferrante Emanuele
Publication year - 2022
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13753
Subject(s) - copeptin , medicine , interquartile range , hazard ratio , septic shock , sepsis , receiver operating characteristic , intensive care unit , clinical endpoint , confidence interval , vasopressin , clinical trial
Background Biomarkers are used for diagnosis, risk stratification and medical decisions. Copeptin and mid‐regional proadrenomedullin (MR‐proADM) are markers of stress and endothelial function, respectively, which have been studied in pneumonia, sepsis and septic shock. This study aimed to assess whether copeptin and MR‐proADM could predict coronavirus disease 2019 (COVID‐19) in‐hospital outcomes, that is multi‐system complications, length of stay and mortality. Methods Copeptin and MR‐proADM were assessed at admission in 116 patients hospitalized with COVID‐19. Data were retrospectively extracted from an online database. The primary endpoint was in‐hospital mortality. The secondary endpoints were in‐hospital complications, the composite outcome ‘death, or admission to intensive care unit, or in‐hospital complications’, and length of stay. The predictive power was expressed as area under the receiver operator characteristic curve (AUROC). Results Copeptin was increased in non‐survivors (median 29.7 [interquartile range 13.0–106.2] pmol/L) compared to survivors (10.9 [5.9–25.3] pmol/L, p < 0.01). The AUROC for mortality was 0.71, with a hazard ratio of 3.67 ( p < 0.01) for copeptin values > 25.3 pmol/L. MR‐proADM differentiated survivors (0.8 [0.6–1.1] nmol/L) from non‐survivors (1.5 [1.1–2.8] nmol/L, p < 0.001) and yielded a AUROC of 0.79 and a hazard ratio of 7.02 ( p < 0.001) for MR‐proADM values > 1.0 nmol/L. Copeptin and MR‐proADM predicted sepsis (AUROC 0.95 and 0.96 respectively), acute kidney injury (0.87 and 0.90), the composite outcome (0.69 and 0.75) and length of stay (r = 0.42, p < 0.001, and r = 0.46, p < 0.001). Conclusions Admission MR‐proADM and copeptin may be implemented for early risk stratification in COVID‐19‐hospitalized patients to help identify those eligible for closer monitoring and care intensification.