Predictive Value of MR-proADM in the Risk Stratification and in the Adequate Care Setting of COVID-19 Patients Assessed at the Triage of the Emergency Department

• Published in: Diagnostics (Basel) Vol. 12; no. 8; p. 1971
• Main Authors: Minieri, Marilena, Di Lecce, Vito N, Lia, Maria Stella, Maurici, Massimo, Leonardis, Francesca, Longo, Susanna, Colangeli, Luca, Paganelli, Carla, Levantesi, Stefania, Terrinoni, Alessandro, Malagnino, Vincenzo, Brunetti, Domenico J, Giovannelli, Alfredo, Pieri, Massimo, Ciotti, Marco, D’Agostini, Cartesio, Gabriele, Mariachiara, Bernardini, Sergio, Legramante, Jacopo M
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.08.2022; MDPI
• Subjects: Biological markers; Biomarkers; Coronaviruses; COVID-19; COVID-19 biomarkers; emergency department; Health aspects; Health risk assessment; Magnetic resonance imaging; Methods; mid-regional proadrenomedullin; Mortality; Peptides; triage; Triage (Medicine); Italy; United States > US
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics12081971

In the past two pandemic years, Emergency Departments (ED) have been overrun with COVID-19-suspicious patients. Some data on the role played by laboratory biomarkers in the early risk stratification of COVID-19 patients have been recently published. The aim of this study is to assess the potential role of the new biomarker mid-regional proadrenomedullin (MR-proADM) in stratifying the in-hospital mortality risk of COVID-19 patients at the triage. A further goal of the present study is to evaluate whether MR-proADM together with other biochemical markers could play a key role in assessing the correct care level of these patients. Data from 321 consecutive patients admitted to the triage of the ED with a COVID-19 infection were analyzed. Epidemiological; demographic; clinical; laboratory; and outcome data were assessed. All the biomarkers analyzed showed an important role in predicting mortality. In particular, an increase of MR-proADM level at ED admission was independently associated with a threefold higher risk of IMV. MR-proADM showed greater ROC curves and AUC when compared to other laboratory biomarkers for the primary endpoint such as in-hospital mortality, except for CRP. This study shows that MR-proADM seems to be particularly effective for early predicting mortality and the need of ventilation in COVID-19 patients admitted to the ED.