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
Marilena Minieri,
Vito N. Di Lecce,
Maria Stella Lia,
Massimo Maurici,
Francesca Leonardis,
Susanna Longo,
Luca Colangeli,
Carla Paganelli,
Stefania Levantesi,
Alessandro Terrinoni,
Vincenzo Malagnino,
Domenico J. Brunetti,
Alfredo Giovannelli,
Massimo Pieri,
Marco Ciotti,
Cartesio D’Agostini,
Mariachiara Gabriele,
Sergio Bernardini,
Jacopo M. Legramante
Affiliations
Marilena Minieri
Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Vito N. Di Lecce
Emergency Department, Tor Vergata University Hospital, 00133 Rome, Italy
Maria Stella Lia
Laboratory Medicine Unit, Tor Vergata University Hospital, 00133 Rome, Italy
Massimo Maurici
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
Francesca Leonardis
Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
Susanna Longo
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Luca Colangeli
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Carla Paganelli
Emergency Department, Tor Vergata University Hospital, 00133 Rome, Italy
Stefania Levantesi
Emergency Department, Tor Vergata University Hospital, 00133 Rome, Italy
Alessandro Terrinoni
Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Vincenzo Malagnino
Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy
Domenico J. Brunetti
Anaesthesia and Intensive Care Unit, Tor Vergata University Hospital, 00133 Rome, Italy
Alfredo Giovannelli
Laboratory Medicine Unit, Tor Vergata University Hospital, 00133 Rome, Italy
Massimo Pieri
Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Marco Ciotti
Virology Unit, Tor Vergata University Hospital, 00133 Rome, Italy
Cartesio D’Agostini
Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Mariachiara Gabriele
Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Sergio Bernardini
Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Jacopo M. Legramante
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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.
