RT Journal Article
SR Electronic
T1 Mid-regional proadrenomedullin (MR-proADM), C-reactive protein (CRP) and other biomarkers in the early identification of disease progression in patients with COVID-19 in the acute NHS setting
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 400
OP 406
DO 10.1136/jclinpath-2021-207750
VO 76
IS 6
A1 Nathan Moore
A1 Rebecca Williams
A1 Matilde Mori
A1 Beatrice Bertolusso
A1 Gabrielle Vernet
A1 Jessica Lynch
A1 Pete Philipson
A1 Thomas Ledgerwood
A1 Stephen P Kidd
A1 Claire Thomas
A1 Veronica Garcia-Arias
A1 Michelle Young
A1 Kordo Saeed
A1 Kirsty Gordon
A1 Nicholas Cortes
YR 2023
UL http://jcp.bmj.com/content/76/6/400.abstract
AB Aims There is a lack of biomarkers validated for assessing clinical deterioration in patients with COVID-19 on presentation to secondary or tertiary care. This evaluation looked at the potential clinical application of C reactive protein (CRP), procalcitonin, mid-regional proadrenomedullin (MR-proADM) and white cell count to support prediction of clinical outcomes.Methods 135 patients presenting to Hampshire Hospitals NHS Foundation Trust between April and June 2020 confirmed to have COVID-19 via reverse-transcription-qPCR were included. Biomarkers from within 24 hours of presentation were used to predict disease progression by Cox regression and area under the receiver operating characteristic curves. The endpoints assessed were 30-day all-cause mortality, intubation and ventilation, critical care admission and non-invasive ventilation (NIV) use.Results Elevated MR-proADM was shown to have the greatest ability to predict 30-day mortality adjusting for age, cardiovascular disease, renal disease and neurological disease. A significant association was also noted between raised MR-proADM and CRP concentrations and the requirement for critical care admission and NIV.Conclusions The measurement of MR-proADM and CRP in patients with confirmed COVID-19 infection on admission shows significant potential to support clinicians in identifying those at increased risk of disease progression and need for higher level care, subsequently enabling prompt escalation in clinical interventions.Data are available upon reasonable request for up to 3 years after publication.