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Article

Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study

1
Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Department of Pathophysiology and Transplantation, University of Milano, 20122 Milan, Italy
3
Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
4
Laboratory of Clinical Epidemiology, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Elisa Vicenzi and Massimo Pizzato
Viruses 2022, 14(8), 1683; https://doi.org/10.3390/v14081683 (registering DOI)
Received: 4 July 2022 / Revised: 26 July 2022 / Accepted: 29 July 2022 / Published: 30 July 2022
(This article belongs to the Special Issue State-of-the-Art SARS-CoV-2 Research in Italy)
Coagulopathy and immune dysregulation have been identified as important causes of adverse outcomes in coronavirus disease (COVID-19). Mid-region proadrenomedullin (MR-proADM) is associated with endothelial damage and has recently been proposed as a prognostic factor in COVID-19. In non-COVID-19 immunocompromised patients, low in vitro interferon gamma (IFNγ) production correlates with infection risk and mortality. This prospective, monocentric, observational study included adult patients consecutively admitted with radiologic evidence of COVID-19 pneumonia and respiratory failure. MR-proADM and in vitro IFNγ production were measured at T0 (day 1 from admission) and T1 (day 7 from enrollment). One hundred patients were enrolled. Thirty-six percent were females, median age 65 (Q1–Q3 54.5–75) years, and 58% had ≥1 comorbidity. Only 16 patients had received COVID-19 vaccination before hospitalization. At admission, the median PaO2:FiO2 ratio was 241 (157–309) mmHg. In-hospital mortality was 13%. MR-proADM levels differed significantly between deceased and survivors both at T0 (1.41 (1.12–1.77) nmol/L vs. 0.79 (0.63–1.03) nmol/L, p < 0.001) and T1 (1.67 (1.08–1.96) nmol/L vs. 0.66 (0.53–0.95) nmol/L, p < 0.001). In vitro IFNγ production at T0 and T1 did not vary between groups. When only the subset of non-vaccinated patients was considered, both biomarkers at T1 resulted significantly associated with in-hospital mortality. AUROC for MR-proADM at T0 to predict in-hospital mortality was 0.87 (95%CI 0.79–0.94), with the best cut-off point at 1.04 nmol/L (92% sensitivity, 75% specificity and 98% negative predictive value). In patients with COVID-19 pneumonia and different degrees of respiratory failure, MR-proADM at admission and during hospitalization resulted strongly associated with in-hospital mortality. Low in vitro IFNγ production after the first week of hospitalization was associated with mortality in non-vaccinated patients possibly identifying the subgroup characterized by a higher degree of immune suppression. View Full-Text
Keywords: mid-region proadrenomedullin; interferon gamma; MR-proADM; quantiferon monitor; SARS-CoV-2 mid-region proadrenomedullin; interferon gamma; MR-proADM; quantiferon monitor; SARS-CoV-2
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MDPI and ACS Style

Mangioni, D.; Oggioni, M.; Chatenoud, L.; Liparoti, A.; Uceda Renteria, S.; Alagna, L.; Biscarini, S.; Bolis, M.; Di Modugno, A.; Mussa, M.; Renisi, G.; Ungaro, R.; Muscatello, A.; Gori, A.; Ceriotti, F.; Bandera, A. Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study. Viruses 2022, 14, 1683. https://doi.org/10.3390/v14081683

AMA Style

Mangioni D, Oggioni M, Chatenoud L, Liparoti A, Uceda Renteria S, Alagna L, Biscarini S, Bolis M, Di Modugno A, Mussa M, Renisi G, Ungaro R, Muscatello A, Gori A, Ceriotti F, Bandera A. Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study. Viruses. 2022; 14(8):1683. https://doi.org/10.3390/v14081683

Chicago/Turabian Style

Mangioni, Davide, Massimo Oggioni, Liliane Chatenoud, Arianna Liparoti, Sara Uceda Renteria, Laura Alagna, Simona Biscarini, Matteo Bolis, Adriana Di Modugno, Marco Mussa, Giulia Renisi, Riccardo Ungaro, Antonio Muscatello, Andrea Gori, Ferruccio Ceriotti, and Alessandra Bandera. 2022. "Prognostic Value of Mid-Region Proadrenomedullin and In Vitro Interferon Gamma Production for In-Hospital Mortality in Patients with COVID-19 Pneumonia and Respiratory Failure: An Observational Prospective Study" Viruses 14, no. 8: 1683. https://doi.org/10.3390/v14081683

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