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A multicenter study of asymmetric and symmetric dimethylarginine as predictors of mortality risk in hospitalized COVID-19 patients.

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  • معلومة اضافية
    • المصدر:
      Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: London : Nature Publishing Group, copyright 2011-
    • الموضوع:
      Arginine*/analogs & derivatives ; Arginine*/blood ; COVID-19*/mortality ; COVID-19*/blood ; Biomarkers*/blood ; Hospitalization*; Humans ; Male ; Female ; Middle Aged ; Aged ; SARS-CoV-2/isolation & purification ; Germany/epidemiology ; Prognosis ; Adult ; Aged, 80 and over ; Risk Factors
    • نبذة مختصرة :
      Mortality of patients hospitalized with COVID-19 has remained high during the consecutive SARS-CoV-2 pandemic waves. Early discrimination of patients at high mortality risk is crucial for optimal patient care. Symmetric (SDMA) and asymmetric dimethylarginine (ADMA) have been proposed as possible biomarkers to improve risk prediction of COVID-19 patients. We measured SDMA, ADMA, and other L-arginine-related metabolites in 180 patients admitted with COVID-19 in four German university hospitals as compared to 127 healthy controls. Patients were treated according to accepted clinical guidelines and followed-up until death or hospital discharge. Classical inflammatory markers (leukocytes, CRP, PCT), renal function (eGFR), and clinical scores (SOFA) were taken from hospital records. In a small subgroup of 23 COVID-19 patients, sequential blood samples were available and analyzed for biomarker trends over time until 14 days after admission. Patients had significantly elevated SDMA, ADMA, and L-ornithine and lower L-citrulline concentrations than controls. Within COVID-19 patients, SDMA and ADMA were significantly higher in non-survivors (n = 41, 22.8%) than in survivors. In ROC analysis, the optimal cut-off to discriminate non-survivors from survivors was 0.579 µmol/L for SDMA and 0.599 µmol/L for ADMA (both p < 0.001). High SDMA and ADMA were associated with odds ratios for death of 11.45 (3.37-38.87) and 5.95 (2.63-13.45), respectively. Analysis of SDMA and ADMA allowed discrimination of a high-risk (mortality, 43.7%), medium-risk (15.1%), and low-risk group (3.6%); risk prediction was significantly improved over classical laboratory markers. We conclude that analysis of ADMA and SDMA after hospital admission significantly improves risk prediction in COVID-19.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Biomarker; Infectious diseases; Intensive care; Nitric oxide
    • الرقم المعرف:
      94ZLA3W45F (Arginine)
      0 (Biomarkers)
      63CV1GEK3Y (N,N-dimethylarginine)
      49787G1ULV (symmetric dimethylarginine)
    • الموضوع:
      Date Created: 20240708 Date Completed: 20240708 Latest Revision: 20240831
    • الموضوع:
      20240831
    • الرقم المعرف:
      PMC11231343
    • الرقم المعرف:
      10.1038/s41598-024-66288-3
    • الرقم المعرف:
      38977837