Systematic review with meta-analysis of mid-regional pro-adrenomedullin (MR-proadm) as a prognostic marker in Covid-19-hospitalized patients

Figures & data

Figure 1. Meta-analysis flow chart of included and excluded studies.

Table 1. Characteristics of included trials.

Study	Country	Study design	Survivors group						Non-survivors group						NOS score
			No. of patients	Age	Sex, male	BMI	Hypertension	Diabetes mellitus	No. of patients	Age	Sex, male	BMI	Hypertension	Diabetes mellitus
Astapovskii et al. 2022	Russia	Prospective, observational study	110	66 (62–67)	38	NS	66 (60.0%)	14 (12.7%)	30	76 (73.2–78.2)	10	NS	23 (76.6%)	10 (33.3%)	8
Atallah et al. 2022	USA	Retrospective analysis of prospective trial	173	NS	NS	NS	NS	NS	9	NS	NS	NS	NS	NS	7
De Montmollin et al. 2022	France	Prospective, observational study	89	58.3 (49.2–66.1)	59	29.6 (26.3–34)	NS	NS	46	71.1 (62.3–75.9)	33	28.6 (24.3–31.2)	NS	NS	8
Fabris et al. 2022	Italy	Retrospective observational study	350	67.4 (55.6–77.2)	228 (65.1%)	NS	NS	NS	65	77.6 (69.4–83.7)	44 (67.7%)	NS	NS	NS	7
García de Guadiana- Romualdo et al. 2021	Spain	Prospective, observational study	327	57 (46–68)	209 (63.9%)	NS	143 (43.7%)	73 (22.3%)	32	76 (65–82)	21 (65.6%)	NS	22 (68.8%)	18 (56.3%)	8
Gregoriano et al. 2021	Switzerland	Prospective, observational study	72	63 (55.5–74.0)	42 (58.3%)	NS	39 (54.2%)	17 (23.6%)	17	74 (69–80)	16 (94.1%)	NS	13 (76.5%)	4 (23.5%)	7
Indirli et al. 2022	Italy	Retrospective observational study	95	NS	NS	NS	NS	NS	21	NS	NS	NS	NS	NS	8
Mangioni et al. 2022	Italy	Prospective, observational study	87	63 (53–73)	56	25.5 (23.4–29.4)	35 (40.2%)	NS	13	77 (73–82)	8	29.3 (27–31.9)	8 (61.5%)	NS	8
Minieri et al. 2022	Italy	Retrospective observational study	224	59.6 (14.6)	145 (64.7%)	NS	70 (31.3%)	19 (8.5%)	97	71.9 (11.2)	70 (70.2%)	NS	61 (62.9%)	23 (23.7%)	8
Montrucchio et al. 2021	Italy	Prospective, observational study	26	59 (53–67)	22 (84.6%)	NS	13 (50.0%)	2 (7.7%)	31	67 (56–74)	28 (90.3%)	NS	18 (58.1%)	9 (29.0%)	8
Moore et al. 2022	United Kingdom	Prospective, observational study	105	NS	NS	NS	NS	NS	30	NS	NS	NS	NS	NS	7
Oblitas et al. 2021	Spain	Prospective, observational study	83	58.7 ± 12.5	55 (66.3)	29 ± 4.7	NS	NS	12	71.3 ± 9.1	9 (75.0%)	29 ± 6.8	NS	NS	8
Popov et al. 2022	Russia	Prospective, observational study	115	62.2 (50.3–71.4)	NS	28.7 (25.8–32.3)	NS	NS	20	73.4 (63.5–84.8)	NS	27.6 (23.5–31.6)	NS	NS	8
van Oers et al. 2021	The Netherlands	Prospective, observational study	75	65 (58–73)	56 (74.7%)	28.3 (25.8–32.3)	20 (26.7%)	17 (22.7%)	30	72 (67–76)	24 (80.0%)	29.2 (25.5–33.3)	9 (30.0%)	7 (23.3%)	7

NOS: Newcastle Ottawa Scale; NS: not specified.

Figure 2. Forest plot of MR-proADM levels in survivors vs. non-survivors COVID-19 patients.

Table 2. Pooled analysis of MR-proADM among different patients subgroups.

Adverse event	No. of studies	MR-proADM levels		MD	95%CI	p-Value for differences across groups
		AE occurance group	AE non-occurance group
Admission to ICU	1	0.975 (0.33)	0.875 (0.083)	0.10	−0.12 to 0.32	0.36
ARDS	1	0.85 (0.268)	0.925 (0.117)	−0.08	−0.22 to 0.07	0.32
Sepsis	1	5.125 (1.523)	0.9 (0.1)	4.22	2.73 to 5.72	<0.001
VTE	1	1.0 (0.268)	0.9 (0.1)	0.10	−0.10 to 0.30	0.33
AKI	1	3.425 (1.323)	0.9 (0.1)	2.52	1.23 to 3.82	<0.001
Cardiological complications	1	1.025 (0.125)	0.925 (0.117)	0.10	0.04 to 0.16	0.002
Neurological complications	1	1.475 (0.5)	0.9 (0.1)	0.58	0.26 to 0.89	<0.001

AE: adverse event; AKI: acute kidney injury; ARDS: acute respiratory distress syndrome; CI: confidence interval; ICU: intensive care unit; MD: mean difference; VTE: venous thrombotic event.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author (L.S.).