Bioactive Adrenomedullin and Interleukin-6 in COVID-19: Potential Biomarkers of Acute Kidney Injury and Critical Illness

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2024 Feb 9

PMID 38336628

Authors

Simon B Leininger

Stephan T Staudner

Manuel J Vogel

Julian Mustroph

Ute Hubauer

Stefan Wallner

Petra Lehn

Ralph Burkhardt

Christine Meindl

Frank Hanses

Markus Zimmermann

Lars S Maier

Julian Hupf

Carsten G Jungbauer

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to investigate whether bioactive adrenomedullin (bio-ADM) and interleukin-6 (IL-6) are related to acute kidney injury (AKI) and severe illness in COVID-19 patients.

Methods: 153 patients with COVID-19 admitted to the emergency department (ED) were included. Blood samples were collected from each patient at admission. Bio-ADM and IL-6, as well as DPP3 and routinely measured markers were evaluated regarding the endpoints AKI (22/128 hospitalized patients) and a composite endpoint of admission to intensive care unit and/or in-hospital death (n = 26/153 patients).

Results: Bio-ADM and IL-6 were significantly elevated in COVID-19 patients with AKI compared to COVID-19 patients without AKI (each p < 0.001). According to ROC analyses IL-6 and bio-ADM had the largest AUC (0.84 and 0.81) regarding the detection of AKI. Furthermore, bio-ADM and IL-6 were significantly elevated in COVID-19 patients reaching the composite endpoint (each p < 0.001). Regarding the composite endpoint ROC analysis showed an AUC of 0.89 for IL-6 and 0.83 for bio-ADM in COVID-19 patients. In the multivariable logistic model bio-ADM and IL-6 presented as independent significant predictors regarding both endpoints AKI and the composite endpoint in COVID-19 patients (as well as creatinine regarding the composite endpoint; each p < 0.05), opposite to leukocytes, C-reactive protein (CRP) and dipeptidyl peptidase 3 (DPP3; each p = n.s.).

Conclusion: Elevated levels of bio-ADM and IL-6 are associated with AKI and critical illness in patients with COVID-19. Therefore, both biomarkers may be potential tools in risk stratification in COVID-19 patients at presentation in the ED.

Citing Articles

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The Role of Adrenomedullin as a Predictive Marker of the Risk of Death and Adverse Clinical Events: A Review of the Literature.

Sacco M, Gualtieri S, Cordasco F, Tarallo A, Verrina M, Princi A J Clin Med. 2024; 13(16).

PMID: 39200990 PMC: 11355278. DOI: 10.3390/jcm13164847.

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