Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department

doi:10.3390/diagnostics13172829

. 2023 Aug 31;13(17):2829.

doi: 10.3390/diagnostics13172829.

Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department

Cartesio D'Agostini^{1

2}, Jacopo M Legramante^{3

4}, Marilena Minieri^{1

5}, Vito N Di Lecce⁴, Maria Stella Lia⁵, Massimo Maurici⁶, Ilaria Simonelli⁷, Marco Ciotti⁸, Carla Paganelli⁴, Alessandro Terrinoni^{1

5}, Alfredo Giovannelli⁵, Massimo Pieri^{1

5}, Mariacarla Gallù^{3

4}, Vito Dell'Olio^{9

10}, Carla Prezioso¹¹, Dolores Limongi¹², Sergio Bernardini^{1

5}, Antonio Orlacchio^{9

10}

Affiliations

¹ Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
² Laboratory of Microbiology, Polyclinic of "Tor Vergata", 00133 Rome, Italy.
³ Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
⁴ Emergency Department, Tor Vergata University Hospital, 00133 Rome, Italy.
⁵ Unit of Laboratory Medicine, Tor Vergata University Hospital, 00133 Rome, Italy.
⁶ Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
⁷ Nursing Science and Public Health, University of Rome Tor Vergata, 00133 Rome, Italy.
⁸ Unit of Virology, Tor Vergata University Hospital, 00133 Rome, Italy.
⁹ Department of Surgical Science, University of Rome Tor Vergata, 00133 Rome, Italy.
¹⁰ Emergency Radiology Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
¹¹ Laboratory of Microbiology of Chronic-Neurodegenerative Diseases, IRCCS San Raffaele Roma, 00166 Rome, Italy.
¹² Department of Human Sciences and Quality of Life Promotion, San Raffaele University, 00166 Rome, Italy.

PMID: 37685368
PMCID: PMC10486389
DOI: 10.3390/diagnostics13172829

Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department

Cartesio D'Agostini et al. Diagnostics (Basel). 2023.

. 2023 Aug 31;13(17):2829.

doi: 10.3390/diagnostics13172829.

Authors

Affiliations

¹ Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
² Laboratory of Microbiology, Polyclinic of "Tor Vergata", 00133 Rome, Italy.
³ Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
⁴ Emergency Department, Tor Vergata University Hospital, 00133 Rome, Italy.
⁵ Unit of Laboratory Medicine, Tor Vergata University Hospital, 00133 Rome, Italy.
⁶ Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
⁷ Nursing Science and Public Health, University of Rome Tor Vergata, 00133 Rome, Italy.
⁸ Unit of Virology, Tor Vergata University Hospital, 00133 Rome, Italy.
⁹ Department of Surgical Science, University of Rome Tor Vergata, 00133 Rome, Italy.
¹⁰ Emergency Radiology Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
¹¹ Laboratory of Microbiology of Chronic-Neurodegenerative Diseases, IRCCS San Raffaele Roma, 00166 Rome, Italy.
¹² Department of Human Sciences and Quality of Life Promotion, San Raffaele University, 00166 Rome, Italy.

PMID: 37685368
PMCID: PMC10486389
DOI: 10.3390/diagnostics13172829

Abstract

Background: It has been reported that mid-regional proadrenomedullin (MR-proADM) could be considered a useful tool to stratify the mortality risk in COVID-19 patients upon admission to the emergency department (ED). During the COVID-19 outbreak, computed tomography (CT) scans were widely used for their excellent sensitivity in diagnosing pneumonia associated with SARS-CoV-2 infection. However, the possible role of CT score in the risk stratification of COVID-19 patients upon admission to the ED is still unclear.

Aim: The main objective of this study was to assess if the association of the CT findings alone or together with MR-proADM results could ameliorate the prediction of in-hospital mortality of COVID-19 patients at the triage. Moreover, the hypothesis that CT score and MR-proADM levels together could play a key role in predicting the correct clinical setting for these patients was also evaluated.

Methods: Epidemiological, demographic, clinical, laboratory, and outcome data were assessed and analyzed from 265 consecutive patients admitted to the triage of the ED with a SARS-CoV-2 infection.

Results and conclusions: The accuracy results by AUROC analysis and statistical analysis demonstrated that CT score is particularly effective, when utilized together with the MR-proADM level, in the risk stratification of COVID-19 patients admitted to the ED, thus helping the decision-making process of emergency physicians and optimizing the hospital resources.

Keywords: CT score; MR-proadrenomedullin; emergency department; laboratory biomarkers.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
ROC curves with the association of candidate biomarkers and CT score with mortality (**left panel**) and mechanical ventilation (**right panel**). MR-proADM, mid-regional proadrenomedullin; IMV, invasive mechanical ventilation.

See this image and copyright information in PMC

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References

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1. McGregor D.O., Troughton R.W., Frampton C., Lynn K.L., Yandle T., Richards A.M., Nicholls M.G. Hypotensive and natriuretic actions of adrenomedullin in subjects with chronic renal impairment. Hypertension. 2001;37:1279–1284. doi: 10.1161/01.HYP.37.5.1279. - DOI - PubMed
1. Kamoi H., Kanazawa H., Hirata K., Kurihara N., Yano Y., Otani S. Adrenomedullin inhibits the secretion of cytokine-induced neutrophil chemoattractant, a member of the interleukin-8 family, from rat alveolar macrophages. Biochem. Biophys. Res. Commun. 1995;211:1031–1035. doi: 10.1006/bbrc.1995.1914. - DOI - PubMed
1. Temmesfeld-Wollbrück B., Brell B., Dávid I., Dorenberg M., Adolphs J., Schmeck B., Suttorp N., Hippenstiel S. Adrenomedullin reduces vascular hyperpermeability and improves survival in rat septic shock. Intensive Care Med. 2007;33:703–710. doi: 10.1007/s00134-007-0561-y. - DOI - PubMed

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[1] Astapovskii A.A., Drozdov V.N., Shikh E.V., Melkonyan G.G., Sizova Z.M., Zakharova V.L., Shindryaeva N.N., Lapidus N.I. Prognostic value of proadrenomedullin in patients with COVID-19 pneumonia. Front. Med. 2022;9:961071. doi: 10.3389/fmed.2022.961071. - DOI - PMC - PubMed

[2] Astapovskii A.A., Drozdov V.N., Shikh E.V., Melkonyan G.G., Sizova Z.M., Zakharova V.L., Shindryaeva N.N., Lapidus N.I. Prognostic value of proadrenomedullin in patients with COVID-19 pneumonia. Front. Med. 2022;9:961071. doi: 10.3389/fmed.2022.961071. - DOI - PMC - PubMed

[3] Nakamura M., Yoshida H., Makita S., Arakawa N., Niinuma H., Hiramori K. Potent and long-lasting vasodilatory effects of adrenomedullin in humans. Circulation. 1997;95:1214–1221. doi: 10.1161/01.CIR.95.5.1214. - DOI - PubMed

[4] Nakamura M., Yoshida H., Makita S., Arakawa N., Niinuma H., Hiramori K. Potent and long-lasting vasodilatory effects of adrenomedullin in humans. Circulation. 1997;95:1214–1221. doi: 10.1161/01.CIR.95.5.1214. - DOI - PubMed

[5] McGregor D.O., Troughton R.W., Frampton C., Lynn K.L., Yandle T., Richards A.M., Nicholls M.G. Hypotensive and natriuretic actions of adrenomedullin in subjects with chronic renal impairment. Hypertension. 2001;37:1279–1284. doi: 10.1161/01.HYP.37.5.1279. - DOI - PubMed

[6] McGregor D.O., Troughton R.W., Frampton C., Lynn K.L., Yandle T., Richards A.M., Nicholls M.G. Hypotensive and natriuretic actions of adrenomedullin in subjects with chronic renal impairment. Hypertension. 2001;37:1279–1284. doi: 10.1161/01.HYP.37.5.1279. - DOI - PubMed

[7] Kamoi H., Kanazawa H., Hirata K., Kurihara N., Yano Y., Otani S. Adrenomedullin inhibits the secretion of cytokine-induced neutrophil chemoattractant, a member of the interleukin-8 family, from rat alveolar macrophages. Biochem. Biophys. Res. Commun. 1995;211:1031–1035. doi: 10.1006/bbrc.1995.1914. - DOI - PubMed

[8] Kamoi H., Kanazawa H., Hirata K., Kurihara N., Yano Y., Otani S. Adrenomedullin inhibits the secretion of cytokine-induced neutrophil chemoattractant, a member of the interleukin-8 family, from rat alveolar macrophages. Biochem. Biophys. Res. Commun. 1995;211:1031–1035. doi: 10.1006/bbrc.1995.1914. - DOI - PubMed

[9] Temmesfeld-Wollbrück B., Brell B., Dávid I., Dorenberg M., Adolphs J., Schmeck B., Suttorp N., Hippenstiel S. Adrenomedullin reduces vascular hyperpermeability and improves survival in rat septic shock. Intensive Care Med. 2007;33:703–710. doi: 10.1007/s00134-007-0561-y. - DOI - PubMed

[10] Temmesfeld-Wollbrück B., Brell B., Dávid I., Dorenberg M., Adolphs J., Schmeck B., Suttorp N., Hippenstiel S. Adrenomedullin reduces vascular hyperpermeability and improves survival in rat septic shock. Intensive Care Med. 2007;33:703–710. doi: 10.1007/s00134-007-0561-y. - DOI - PubMed

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Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department

Affiliations

Correlation between Chest Computed Tomography Score and Laboratory Biomarkers in the Risk Stratification of COVID-19 Patients Admitted to the Emergency Department

Authors

Affiliations

Abstract

Conflict of interest statement

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