• Jos A H van Oers, Yvette Kluiters, Judith A P Bons, Mariska de Jongh, Sjaak Pouwels, Dharmanand Ramnarain, Dylan W de Lange, Harm-Jan de Grooth, and GirbesArmand R JARJDepartment of Intensive Care Medicine, Amsterdam UMC, Medical Centres, VU University Medical Centre, Amsterdam, the Netherlands. Electronic address: ARJ.Girbes@amsterdamumc.nl..
• Department of Intensive Care Medicine, Elisabeth Tweesteden Ziekenhuis, Tilburg, the Netherlands. Electronic address: jah.vanoers@etz.nl.
• J Crit Care. 2021 Dec 1; 66: 173180173-180.

PurposeWe assessed the ability of mid-regional proadrenomedullin (MR-proADM) and C-terminal proendothelin-1 (CT-proET-1) to predict 28-day mortality in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.MethodsBiomarkers were collected during the first seven days in this prospective observational cohort study. We investigated the relationship between biomarkers and mortality in a multivariable Cox regression model adjusted for age and SOFA score.ResultsIn 105 critically ill patients with confirmed SARS-CoV-2 pneumonia 28-day mortality was 28.6%. MR-proADM and CT-proET-1 were significantly higher in 28-day non-survivors at baseline and over time. ROC curves revealed high accuracy to identify non-survivors for baseline MR-proADM and CT-proET-1, AUC 0.84, (95% CI 0.76-0.92), p < 0.001 and 0.79, (95% CI 0.69-0.89), p < 0.001, respectively. The AUC for prediction of 28-day mortality for MR-proADM and CT-proET-1 remained high over time. MR-proADM ≥1.57 nmol/L and CT-proET-1 ≥ 111 pmol/L at baseline were significant predictors for 28-day mortality (HR 6.80, 95% CI 3.12-14.84, p < 0.001 and HR 3.72, 95% CI 1.71-8.08, p 0.01).ConclusionBaseline and serial MR-proADM and CT-proET-1 had good ability to predict 28-day mortality in critically ill patients with SARS-CoV-2 pneumonia.Trial RegistrationNEDERLANDS TRIAL REGISTER, NL8460.Copyright © 2021 Elsevier Inc. All rights reserved.

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