MR-proADM和单核细胞CD169在预测COVID-19患者住院及60天死亡率中的作用

Role of MR-proADM and Monocyte CD169 in Predicting In-Hospital and 60-Day Mortality in COVID-19 Patients.

作者信息

Venturini Sergio, Orso Daniele, Cugini Francesco, Del Fabro Giovanni, Callegari Astrid, Reffo Ingrid, Villalta Danilo, de Santi Laura, Pontoni Elisa, Giordani Dina, Doretto Paolo, Pratesi Chiara, Tonizzo Maurizio, Colussi Gian Luca, Crapis Massimo

机构信息

Department of Infectious Diseases, ASFO "Santa Maria degli Angeli" Hospital, Pordenone, Italy.

Department of Anesthesia and Intensive Care, ASUFC "Santa Maria della Misericordia" University Hospital, Udine, Italy.

出版信息

Clin Pathol. 2024 Dec 16;17:2632010X241304958. doi: 10.1177/2632010X241304958. eCollection 2024 Jan-Dec.

OBJECTIVES

Mid-regional pro-adrenomedullin (MR-proADM) and monocyte CD169 (CD169) are valuable prognostic indicators of severe COVID-19.

METHODS

We assessed the predictive ability of a single measurement of MR-proADM and CD169 at emergency department (ED) admission to forecast in-hospital and 60-day mortality in adult COVID-19 patients. We analyzed clinical and laboratory data, with in-hospital mortality as the primary endpoint and 60-day mortality as the secondary endpoint. We examined associations with clinical and laboratory variables through univariate and multivariate analyses.

RESULTS

Data from 382 patients over 14 months were analyzed. Significant predictors of in-hospital mortality included age ⩾ 70 years (hazard ratio [HR] 8.1; 95% confidence interval [CI] 2.2-29.5), CD169 ratio ⩾ 20 (HR: 2.4; 95%CI: 1.6-5.6), MR-proADM ⩾ 1.1 mmol/L (HR: 5.1; 95%CI: 1.7-15.6), the need for invasive mechanical ventilation (HR: 6.8; 95%CI: 2.4-19.1), and active cancer (HR: 5.2; 95%CI: 1.8-15.2). For 60-day mortality, only elevated MR-proADM levels showed predictive value (HR: 6.7; 95%CI: 1.7-25.0), while high serologic titer was protective (HR: 0.4; 95%CI: 0.1-0.9).

CONCLUSION

A single MR-proADM and CD169 measurement upon ED admission has prognostic value for in-hospital mortality, with MR-proADM also predicting 60-day mortality.

目的

中段肾上腺髓质素原（MR-proADM）和单核细胞CD169（CD169）是重症新型冠状病毒肺炎（COVID-19）的重要预后指标。

方法

我们评估了急诊科（ED）入院时单次检测MR-proADM和CD169对成人COVID-19患者院内及60天死亡率的预测能力。我们分析了临床和实验室数据，以院内死亡率作为主要终点，60天死亡率作为次要终点。我们通过单因素和多因素分析研究了与临床和实验室变量的关联。

结果

分析了14个月内382例患者的数据。院内死亡的显著预测因素包括年龄≥70岁（风险比[HR]8.1；95%置信区间[CI]2.2-29.5）、CD169比率≥20（HR：2.4；95%CI：1.6-5.6）、MR-proADM≥1.1 mmol/L（HR：5.1；95%CI：1.7-15.6）、需要有创机械通气（HR：6.8；95%CI：2.4-19.1）和活动性癌症（HR：5.2；95%CI：1.8-15.2）。对于60天死亡率，只有MR-proADM水平升高显示出预测价值（HR：6.7；95%CI：1.7-25.0），而高血清学滴度具有保护作用（HR：0.4；95%CI：0.1-0.9）。