Plasma Levels of Mid-Regional Proadrenomedullin Accurately Identify H1N1pdm09 Influenza Virus Patients with Risk of Intensive Care Admission and Mortality in the Emergency Department
Valenzuela-Méndez, Blanca (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Valenzuela-Sánchez, Francisco (Hospital Universitario de Jerez (Jerez de la Frontera))
Rodríguez-Gutiérrez, Juan Francisco (Hospital Universitario de Jerez (Jerez de la Frontera))
Bohollo-de-Austria, Rafael (Hospital Universitario de Jerez (Jerez de la Frontera))
Estella, Ángel (Universidad de Cádiz)
Martínez-García, Pilar (Hospital Universitario Puerto Real (Cadis))
González-García, María Ángela (Hospital Universitario de Jerez (Jerez de la Frontera))
Rello, Jordi (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Early identification of severe viral pneumonia in influenza virus A (H1N1pdm09) patients is extremely important for prompt admission to the ICU. The objective is to evaluate the usefulness of MR-proadrenomedullin (MR-proADM) compared to C reactive protein (CRP), procalcitonin (PCT), and ferritin in the prognosis of influenza A pneumonia. This prospective, observational, multicenter study included one hundred thirteen patients with confirmed influenza virus A (H1N1pdm09) admitted to an Emergency Department and ICUs of six hospitals in Spain. Measurements and Main Results: one-hundred thirteen patients with confirmed influenza virus A (H1N1pdm09) were enrolled. Seventy-five subjects (mortality 29. 3%) with severe pneumonia caused by influenza A H1N1pdm09 virus (H1N1vIPN) were compared with 38 controls (CG). The median MR-proADM levels at hospital admission were 1. 2 nmol/L (IQR (0. 8-2. 6) vs. 0. 5 nmol/L (IQR 0. 2-0. 9) in the CG (p = 0. 01), and PCT levels were 0. 43 μg/L (IQR 0. 2-1. 2) in the H1N1vIPN group and 0. 1 μg/L (IQR 0. 1-0. 2) in the CG (p < 0. 01). CRP levels at admission were 15. 5 mg/dL(IQR 9. 2-24. 9) in H1N1vIPN and 8. 6 mg/dL(IQR 3-17. 3) in the CG (p < 0. 01). Ferritin levels at admission were 558. 1 ng/mL(IQR 180-1880) in H1N1vIPN and 167. 7 ng/mL(IQR 34. 8-292. 9) in the CG (p < 0. 01). A breakpoint for hospital admission of MR-proADM of 1. 1 nmol/L showed a sensitivity of 55% and a specificity of 90% (AUC-ROC0. 822). Non-survivors showed higher MR-proADM levels: median of 2. 5 nmol/L vs. 0. 9 nmol/L among survivors (p < 0. 01). PCT, CRP, and ferritin levels also showed significant differences in predicting mortality. The MR-proADM AUC-ROC for mortality was 0. 853 (p < 0. 01). In a Cox proportional hazards model, MR-proADM levels.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	H1N1 influenza pneumonia ; Biomarkers ; MR proadrenomedullin ; Procalcitonin ; Ferritin ; CRP ; Sepsis ; Virus ; ICU admission
Publicado en:	Journal of personalized medicine, Vol. 12 (january 2022) , ISSN 2075-4426

DOI: 10.3390/jpm12010084
PMID: 35055399

14 p, 1.9 MB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Instituto de Investigación e Innovación Parc Taulí (I3PT)
Artículos > Artículos de investigación
Artículos > Artículos publicados