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Fialek B, De Roquetaillade C, Pruc M, Navolokina A, Chirico F, Ladny JR, Peacock FW, Szarpak L. Systematic review with meta-analysis of mid-regional pro-adrenomedullin (MR-proadm) as a prognostic marker in Covid-19-hospitalized patients. Ann Med 2023; 55:379-387. [PMID: 36607317 PMCID: PMC9828692 DOI: 10.1080/07853890.2022.2162116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Mid-regional pro-adrenomedullin (MR-proADM) is useful for risk stratification in patients with sepsis and respiratory infections. The study's purpose was to assess the available data and determine the association between MR-proADM levels and mortality in COVID-19 participants. METHODS A comprehensive literature search of medical electronic databases was performed including PubMed, Web of Science, Scopus, Cochrane, and grey literature for relevant data published from 1 January 2020, to 20 November 2022. Mean differences (MD) with 95% confidence intervals (CI) were calculated. RESULTS Fourteen studies reported MR-proADM levels in survivors vs. non-survivors of COVID-19 patients. Pooled analysis showed that MR-proADM level in the survivor group was 0.841 ± 0.295 nmol/L for patients who survive COVID-19, compared to 1.692 ± 0.761 nmol/L for non-survivors (MD = -0.78; 95%CI: -0.92 to -0.64; p < 0.001). CONCLUSIONS The main finding of this study is that mortality of COVID-19 is linked to MR-proADM levels, according to this meta-analysis. The use of MR-proADM might be extremely beneficial in triaging, assessing probable therapy escalation, predicting potential complications during therapy or significant clinical deterioration of patients, and avoiding admission which may not be necessary. Nevertheless, in order to confirm the obtained data, it is necessary to conduct large prospective studies that will address the potential diagnostic role of MR-proADM as a marker of COVID-19 severity.KEY MESSAGESSeverity of COVID-19 seems to be linked to MR-proADM levels and can be used as a potential marker for predicting a patient's clinical course.The use of MR-proADM might be beneficial in triaging, assessing probable therapy escalation, predicting potential complications during therapy or significant clinical deterioration of patients, and avoiding admission which may not be necessary.For patients with COVID-19, MR-proADM may be an excellent prognostic indicator because it is a marker of endothelial function that may predict the precise impact on the equilibrium between vascular relaxation and contraction and lowers platelet aggregation inhibitors, coagulation inhibitors, and fibrinolysis activators in favor of clotting factors.
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Affiliation(s)
- Bartosz Fialek
- Rheumatology Department, Marshal Józef Piłsudski Memorial Hospital, Plonsk, Poland
| | - Charles De Roquetaillade
- Department of Anesthesiology, Burn and Critical Care, University Hospitals Saint-Louis-Lariboisière, AP-HP, Paris, France.,UMR-S 942, Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiovascular Markers in Stressed Conditions (MASCOT), Paris University, Paris, France
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Alla Navolokina
- Department of Public health and Social Medicine, International European University, Kyiv, Ukraine
| | - Francesco Chirico
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy
| | - Jerzy Robert Ladny
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.,Department of Emergency Medicine, Bialystok Medical University, Bialystok, Poland
| | - Frank William Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, USA
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, USA.,Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Research Institute, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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Plais H, Labruyère M, Creutin T, Nay P, Plantefeve G, Tapponnier R, Jonas M, Ngapmen NT, Le Guennec L, De Roquetaillade C, Argaud L, Jamme M, Goulenok C, Merouani K, Leclerc M, Sauneuf B, Shidasp S, Stoclin A, Bardet A, Mir O, Ibrahimi N, Llitjos JF. Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study. Front Oncol 2022; 12:858276. [PMID: 35359407 PMCID: PMC8960921 DOI: 10.3389/fonc.2022.858276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/16/2022] [Indexed: 01/15/2023] Open
Abstract
Background Several studies report an increased susceptibility to SARS-CoV-2 infection in cancer patients. However, data in the intensive care unit (ICU) are scarce. Research Question We aimed to investigate the association between active cancer and mortality among patients requiring organ support in the ICU. Study Design and Methods In this ambispective study encompassing 17 hospitals in France, we included all adult active cancer patients with SARS-CoV-2 infection requiring organ support and admitted in ICU. For each cancer patient, we included 3 non cancer patients as controls. Patients were matched at the same ratio using the inverse probability weighting approach based on a propensity score assessing the probability of cancer at admission. Mortality at day 60 after ICU admission was compared between cancer patients and non-cancer patients using primary logistic regression analysis and secondary multivariable analyses. Results Between March 12, 2020 and March 8, 2021, 2608 patients were admitted with SARS-CoV-2 infection in our study, accounting for 2.8% of the total population of patients with SARS-CoV-2 admitted in all French ICUs within the same period. Among them, 105 (n=4%) presented with cancer (51 patients had hematological malignancy and 54 patients had solid tumors). 409 of 420 patients were included in the propensity score matching process, of whom 307 patients in the non-cancer group and 102 patients in the cancer group. 145 patients (35%) died in the ICU at day 60, 59 (56%) with cancer and 86 (27%) without cancer. In the primary logistic regression analysis, the odds ratio for death associated to cancer was 2.3 (95%CI 1.24 - 4.28, p=0.0082) higher for cancer patients than for a non-cancer patient at ICU admission. Exploratory multivariable analyses showed that solid tumor (OR: 2.344 (0.87-6.31), p=0.062) and hematological malignancies (OR: 4.144 (1.24-13.83), p=0.062) were independently associated with mortality. Interpretation Patients with cancer and requiring ICU admission for SARS-CoV-2 infection had an increased mortality, hematological malignancy harboring the higher risk in comparison to solid tumors.
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Affiliation(s)
- Henri Plais
- Intensive Care Unit, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Marie Labruyère
- Department of Intensive Care, Dijon Bourgogne University Hospital, Dijon, France
| | - Thibault Creutin
- Service de Médecine Intensive and Réanimation, APHP-CUP, Hôpital Cochin, Paris, France
| | - Paula Nay
- Medical Intensive Care Unit, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - Gaëtan Plantefeve
- Service de Réanimation Polyvalente, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Romain Tapponnier
- Medical Intensive Care Unit, Hôpital Jean Minjoz Hospital, Besançon, France
| | - Maud Jonas
- Centre Hospitalier Général de Saint-Nazaire, Service de Médecine Intensive Réanimation, Saint-Nazaire, France
| | | | - Loïc Le Guennec
- Médecine Intensive Réanimation Neurologique, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Charles De Roquetaillade
- Department of Anesthesiology and Critical Care, Hôpital Lariboisière, FHU PROMICE, DMU Parabol, APHP, Paris, France
| | - Laurent Argaud
- Medical ICU, Edouard Herriot University Hospital, Lyon, France
| | - Matthieu Jamme
- Intensive Care Unit, Poissy-Saint-Germain-en-Laye Hospital, Poissy, France
| | - Cyril Goulenok
- Medical-Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France
| | - Karim Merouani
- Medical and Surgical Intensive Care Unit, Alençon Hospital, Alençon, France
| | - Maxime Leclerc
- Intensive Care Unit, Centre Hospitalier Mémorial France Etats-Unis, Saint-Lô, France
| | - Bertrand Sauneuf
- Réanimation - Médecine Intensive, Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Sami Shidasp
- Intensive Care Unit, Etampes Hospital, Etampes, France
| | - Annabelle Stoclin
- Intensive Care Unit, Centre Hospitalier de Château-Thierry, Château-Thierry, France
| | - Aurélie Bardet
- Bureau of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France and U1018 INSERM Oncostat, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - Olivier Mir
- Gustave-Roussy, Département d'oncologie Médicale, Villejuif, France
| | - Nusaibah Ibrahimi
- Bureau of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France and U1018 INSERM Oncostat, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
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