MR-proADM, CRP & other Biomarkers to predict outcome in COVID-19
Research type
Research Study
Full title
Utility of Mid-Regional pro-Adrenomedullin (MR-proADM), C-reactive protein (CRP) and other Biomarkers in the Early Identification of Disease Progression in COVID-19 Patients in the Acute NHS Setting
IRAS ID
299130
Contact name
Nicholas J Cortes
Contact email
Sponsor organisation
Hampshire Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 8 months, 26 days
Research summary
Background: There is a lack of biomarkers validated for assessing the potential for clinical deterioration in COVID-19 patients upon presentation to secondary and tertiary care. This study therefore looked at the effectiveness of biomarkers, such as Mid-Regional pro-adrenomedullin (MR-proADM), C-Reactive Protein (CRP) and Procalcitonin (PCT), to predict clinical outcomes.
Methods: As part of routine clinical care during wave 1 of COVID-19 (March-June 2020) all patients admitted to Hampshire Hospitals NHS Foundation Trust with laboratory-confirmed SARS-CoV-2 infection were anonymised and entered onto a Microbiology departmental clinical COVID-19 database. The dataset included results taken as part of routine clinical care in our NHS Trust over this time period such as existing biomarkers: full blood count (FBC) & differential white cell count (WCC), C-reactive protein (CRP), procalcitonin (PCT) and mid-regional pro-adrenomedullin (MRpro_ADM)- the latter a biomarker under service evaluation in our department at the time, subsequent to previous work (Saeed et al, Crit Care. 2019;23(1):40). Consecutive adult anonymised COVID-19 cases from this database presenting to hospital between April and June 2020 were included for analysis. Biomarkers from within 24 hours of admission, taken as part of routine clinical care at that time, were used to assess effectiveness in predicting disease progression using logistic regression and area under the receiver operating characteristic (AUROC) curves. The endpoints used to assess disease progression were 30-day all-cause mortality, non-invasive ventilation (NIV) use, critical care unit (CCU) admission and intubation.
A total of 135 adult COVID-19 cases were included, amongst which 30 cases were non-survivors.
Levels of biomarkers including CRP, PCT, MRpro-ADM and WCC were investigated for utility to predict 30-day mortality following multivariate Cox regression analysis, with subsequent adjustment for age, cardiovascular disease, renal disease and neurological disease. Biomarker levels were also investigated for their utility in predicting critical care admission and invasive and non-invasive ventilation, after controlling for covariates.REC name
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REC reference
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