Article ; Online: Mid-regional pro-atrial natriuretic peptide independently predicts short-term mortality in COVID-19.
European journal of clinical investigation
2021 Volume 51, Issue 5, Page(s) e13531
Abstract: Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a strong prognostic marker ... severity of COVID-19 and act as a powerful and independent prognostic marker of 28-day mortality. ... 016), while NT-proBNP failed to independently predict 28-day mortality and had a numerically lower AUC ...
| Abstract | Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a strong prognostic marker in several inflammatory, respiratory and cardiovascular conditions, but has not been studied in COVID-19 yet. Methods: This prospective, observational study of patients with COVID-19 infection was conducted from 6 June to 26 November 2020 in different wards of a tertiary hospital. MR-proANP, N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive cardiac troponin I levels on admission were collected and tested for their association with disease severity and 28-day mortality. Results: A total of 213 eligible patients with COVID-19 were included in the final analyses of whom 13.2% (n = 28) died within 28 days. Median levels of MR-proANP at admission were significantly higher in nonsurvivors (307 pmol/L IQR, [161 - 532] vs 75 pmol/L [IQR, 43 - 153], P < .001) compared to survivors and increased with disease severity and level of hypoxaemia. The area under the ROC curve for MR-proANP predicting 28-day mortality was 0.832 (95% CI 0.753 - 0.912, P < .001). An optimal cut-off point of 160 pmol/L yielded a sensitivity of 82.1% and a specificity of 76.2%. MR-proANP was a significant predictor of 28-day mortality independent of clinical confounders, comorbidities and established prognostic markers of COVID-19 (HR 2.77, 95% CI 1.21 - 6.37; P = .016), while NT-proBNP failed to independently predict 28-day mortality and had a numerically lower AUC compared to MR-proANP. Conclusion: Higher levels of MR-proANP at admission are associated with disease severity of COVID-19 and act as a powerful and independent prognostic marker of 28-day mortality. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Atrial Natriuretic Factor/blood ; COVID-19/blood ; Case-Control Studies ; Cause of Death ; Female ; Hospitalization ; Humans ; Hypoxia/blood ; Male ; Middle Aged ; Mortality ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Prospective Studies ; ROC Curve ; SARS-CoV-2 ; Severity of Illness Index ; Troponin I/blood | |||||
| Chemical Substances | Peptide Fragments ; Troponin I ; midregional pro-atrial natriuretic peptide, human ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0) ; Atrial Natriuretic Factor (85637-73-6) | |||||
| Language | English | |||||
| Publishing date | 2021-03-10 | |||||
| Publishing country | England | |||||
| Document type | Journal Article ; Observational Study | |||||
| ZDB-ID | 186196-7 | |||||
| ISSN | 1365-2362 ; 0014-2972 ; 0960-135X | |||||
| ISSN (online) | 1365-2362 | |||||
| ISSN | 0014-2972 ; 0960-135X | |||||
| DOI | 10.1111/eci.13531 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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