• Silvia Spoto, Felice E Agrò, Federica Sambuco, Francesco Travaglino, Emanuele Valeriani, Marta Fogolari, Fabio Mangiacapra, Sebastiano Costantino, Massimo Ciccozzi, and Silvia Angeletti.
• Diagnostic and Therapeutic Medicine Department, University Campus Bio-Medico of Rome, Rome, Italy.
• J. Med. Virol. 2021 May 1; 93 (5): 2820-2827.

AbstractThe widespread endothelial damage due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may lead to a disruption of the adrenomedullin (ADM) system responsible for vascular leakage, increased inflammatory status, and microvascular alteration with multi-organs dysfunction. The aim of this study was to evaluate the role of mid-regional proadrenomedullin (MR-proADM) as a marker of SARS-CoV2 related widespread endothelial damage, clinically identified by organs damage, disease severity and mortality. Patients with SARS-CoV-2 infection has been prospectively enrolled and demographic characteristic, clinical and laboratory data has been evaluated. In the overall population, 58% developed acute respiratory distress syndrome (ARDS), 23.3% of patients died, 6.5% acute cardiac injury, 1.4% of patients developed acute ischemic stroke, 21.2% acute kidney injury, 11.8% acute liver damage, and 5.4% septic shock. The best MR-proADM cut-off values for ARDS development and mortality prediction were 3.04 and 2 nmol/L, respectively. Patients presenting with MR-proADM values ≥2 nmol/L showed a significantly higher mortality risk. In conclusion, MR-proADM values ≥2 nmol/L identify those patients with high mortality risk related to a multiorgan dysfunction syndrome. These patients must be carefully evaluated and considered for an intensive therapeutic approach.© 2020 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.

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