Pro-adrenomedullin for prognosing disease progression in severe acute respiratory syndrome (SARS)
View Patent ↗The invention relates to a method for prognosing disease progression in a patient that has or is at risk of developing a severe acute respiratory syndrome (SARS), wherein the method comprises determining a level of pro-adrenomedullin (proADM) or fragment(s) thereof in a sample from the patient, wherein said level indicates the severity of SARS progression. The method is in some embodiments configured for use when a patient exhibits symptoms of a severe acute respiratory syndrome (SARS), a patient exhibits symptoms of infection with a SARS-virus, the patient is infected with a SARS-virus, such as a SARS-coronavirus, such as SARS-CoV2.
1 . A method for reducing the risk of severe acute respiratory syndrome (SARS) progression in a patient that has SARS, wherein the patient is infected with a SARS-coronavirus, wherein the method comprises determining a level of mid-regional pro-adrenomedullin (MR-proADM) in a sample from the patient, wherein said level indicates the severity of SARS progression, comprising prognosing a subsequent adverse event in the health of the patient, wherein the patient has been diagnosed with SARS, wherein the level of MR-proADM indicates the likelihood of a subsequent adverse event in the health of said patient and treating said patient to reduce the risk of SARS progression, wherein the treatment comprises one or more of a transfer to a clinical setting for intensified treatment, hospitalization, an escalation of therapeutic interventions, symptomatic treatment, treatment to reduce fever and/or pain, anti-inflammatory treatment, antiviral treatment, antibiotic treatment, oxygen support, invasive mechanical ventilation, non-invasive mechanical ventilation, renal replacement therapy, vasopressor use, fluid therapy, extracorporeal blood purification and/or organ protection.
2 . The method according to claim 1 , further comprising therapy guidance, stratification and/or control for the patient, wherein the level of MR-proADM indicates whether the patient is at risk of SARS progression to a condition that requires intensified treatment and/or disease monitoring.
3 . The method according to claim 1 , wherein the patient exhibits symptoms of a severe acute respiratory syndrome (SARS) and/or symptoms of infection with a SARS-coronavirus.
4 . The method according to claim 1 , wherein the patient is infected with SARS-COV-2.
5 . The method according to claim 1 , wherein the patient belongs to a patient group with an increased risk of an adverse event in severe acute respiratory syndrome (SARS).
6 . The method according to claim 1 , wherein the method comprises:
providing a sample from said patient,
determining a level of MR-proADM in said sample,
comparing the level of MR-proADM to a cut-off value, wherein said cut-off value is 0.93 nmol/l±20%,
wherein a level of MR-proADM in said sample above the cut-off value indicates that the patient is at risk of SARS progression to a condition that requires intensified treatment and/or disease monitoring.
7 . The method according to claim 6 ,
wherein a level of MR-proADM in said sample above the cut-off value indicates that the patient is at risk of a SARS progression to a condition that requires hospitalization.
8 . The method according to claim 1 , wherein the patient shows mild or no symptoms of SARS or of infection with a SARS-coronavirus.
9 . The method according to claim 1 , wherein the adverse event in the health of said patient is death, respiratory failure, and/or organ failure.
10 . The method according to claim 1 , wherein a high severity level of MR-proADM determined in the sample is indicative of a subsequent adverse event, wherein the high severity level is above 2.25 nmol/l±20%.
11 . The method according to claim 10 , wherein the patient is an intensive care unit (ICU)-patient and a high severity level of MR-proADM indicates keeping said patient on the ICU and modifying the treatment of the patient in the ICU, or the patient is not an intensive care unit (ICU)-patient and the high severity level of MR-proADM indicates transferring said patient to an ICU.
12 . The method according to claim 1 , wherein the method comprises determining a level of MR-proADM in a sample from the patient obtained within 24 hours of hospital admission, wherein a level of or above 0.93 nmol/l±20% indicates the patient is at risk of SARS progression to a condition that requires intensified treatment and/or disease monitoring.
13 . The method according to claim 1 , wherein the patient is infected with SARS-COV-2.
14 . The method according to claim 1 , wherein the adverse event in the health of said patient is a deterioration of clinical symptoms requiring a focus cleaning procedure, transfusion of blood products, infusion of colloids, emergency surgery, invasive mechanical ventilation and/or renal or liver replacement.
15 . The method according to claim 1 , wherein the method further comprises determining a level of at least one additional biomarker in a sample from said patient.
16 . The method according to claim 15 , wherein the at least one additional biomarker is at least one of procalcitonin (PCT), lactate, creatine kinase (CK), lactate dehydrogenase (LDH), creatinine, myoglobin, aldolase, troponin, carbonic anhydrase type 3, fatty acid-binding protein (FABP), transaminases, potassium, arginine vasopressin (AVP), pro-arginine vasopressin (proAVP), Copeptin (CT-proAVP), Endothelin-1 (ET-1), C-terminal proendothelin-1 (CT-proET-1), and D-Dimer.