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. 2023 Feb 16;12(4):1557.
doi: 10.3390/jcm12041557.

Endogenous Catecholamine Release in COVID-19 Related Acute Respiratory Distress Syndrome: Link between Enhanced Sympathetic Stimulation, Cardiac Dysfunction and Outcome

Valentino Dammassa  1   2 , Marta Voltini  3 , Costanza Natalia Julia Colombo  1   4 , Gilda Maria Siano  3 , Claudia Lo Coco  4 , Vittoria Rizzo  5 , Francesco Corradi  6 , Francesco Mojoli  3   4 , Guido Tavazzi  3   4
Affiliations

Endogenous Catecholamine Release in COVID-19 Related Acute Respiratory Distress Syndrome: Link between Enhanced Sympathetic Stimulation, Cardiac Dysfunction and Outcome

Valentino Dammassa et al. J Clin Med. .

Abstract

The aim of this study was to measure the serum levels of catecholamines in patients admitted to intensive care unit (ICU) with COVID-19-related acute respiratory distress syndrome (ARDS) and describe their relation with clinical, inflammatory and echocardiographic parameters. Serum levels of endogenous catecholamines (norepinephrine, epinephrine and dopamine) were measured at ICU admission. We enrolled 71 patients consecutively admitted to ICU due to moderate to severe ARDS. 11 patients (15.5%) died during the admission in ICU. Serum levels of endogenous catecholamines were significantly elevated. Norepinephrine levels were higher in those with RV and LV systolic dysfunction, higher CRP, and higher IL-6. Patients with higher mortality rate were those with norepinephrine values ≥ 3124 ng/mL, CRP ≥ 17.2 mg/dL and IL-6 ≥ 102 pg/mL. Univariable analysis by Cox proportional hazards regression modelling showed that norepinephrine, IL-6 and CRP had the highest risk of acute mortality. Multivariable analysis showed that only norepinephrine and IL-6 retained in the model. Marked increase of serum catecholamine levels is present during acute phase of critically ill COVID-19 and it is associated with inflammatory and clinical parameters.

Keywords: COVID-19; SARS-CoV-2; acute respiratory distress syndrome; catecholamines; echocardiography; inflammation.

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Conflict of interest statement

F.M. received fees for lectures from G.E. Healthcare, Hamilton Medical, S.E.D.A. SpA, outside the present work. All the other Authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Cumulative survival according to serum norepinephrine levels lower (green line) and higher or equal (blue line) to 3124 ng/mL. “+” means censored.
See this image and copyright information in PMC

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