Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients.
Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients.
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DOI：
10.1038/s41598-021-89180-w
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发表时间：
2021-05-10
影响因子：
4.6
通讯作者：
Böger R
中科院分区：
文献类型：
--
作者：
Hannemann J;Balfanz P;Schwedhelm E;Hartmann B;Ule J;Müller-Wieland D;Dahl E;Dreher M;Marx N;Böger R
COVID-19是一种临床病程多变的疾病，从轻微症状到危重疾病、器官衰竭和死亡。前瞻性生物标志物可能有助于预测个体临床病程的严重程度和死亡风险。我们分析了31名因COVID-19住院的患者的血液样本中的不对称（ADMA）和对称二甲基精氨酸（SDMA）。我们计算了ADMA和SDMA与死亡率和器官衰竭的相关性，并开发了一种基于这些生物标志物的预测算法来预测死亡风险。9例患者（29%）发生院内死亡。死亡的COVID-19患者入院时的SDMA和ADMA血清浓度显著高于幸存者。在ROC分析中发现，SDMA（AUC，0.904，p = 0.0005）和ADMA（AUC，0.874，p = 0.0013）的临界值分别为0.90 µmol/L和0.66 µmol/L，最能区分两个亚组的患者。高于临界值时，SDMA和ADMA的院内死亡风险比分别为12.2（95% CI：2.2-31.2）和6.3（1.1-14.7）。两种生物标志物的顺序分析允许区分高风险组（87.5%死亡率）与中风险组（25%死亡率）和低风险组（0%死亡率）。SDMA和ADMA的循环浓度升高可能有助于更好地识别具有高住院死亡风险的COVID-19患者。
COVID-19 is a disease with a variable clinical course ranging from mild symptoms to critical illness, organ failure, and death. Prospective biomarkers may help to predict the severity of an individual’s clinical course and mortality risk. We analyzed asymmetric (ADMA) and symmetric dimethylarginine (SDMA) in blood samples from 31 patients hospitalized for COVID-19. We calculated associations of ADMA and SDMA with mortality and organ failure, and we developed a predictive algorithm based upon these biomarkers to predict mortality risk. Nine patients (29%) experienced in-hospital death. SDMA and ADMA serum concentrations were significantly higher at admission in COVID-19 patients who died than in survivors. Cut-offs of 0.90 µmol/L for SDMA (AUC, 0.904, p = 0.0005) and 0.66 µmol/L for ADMA (AUC, 0.874, p = 0.0013) were found in ROC analyses to best discriminate both subgroups of patients. Hazard ratio for in-hospital mortality was 12.2 (95% CI: 2.2–31.2) for SDMA and 6.3 (1.1–14.7) for ADMA above cut-off. Sequential analysis of both biomarkers allowed discriminating a high-risk group (87.5% mortality) from an intermediate-risk group (25% mortality) and a low-risk group (0% mortality). Elevated circulating concentrations of SDMA and ADMA may help to better identify COVID-19 patients with a high risk of in-hospital mortality.
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影响因子：
2.6
作者：
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通讯作者：
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