Activation of Vasopressin System During COVID-19 is Associated With Adverse Clinical Outcomes: An Observational Study.

30-day mortality COVID-19 SARS-CoV-2 biomarker copeptin prognostic markers

Journal

Journal of the Endocrine Society
ISSN: 2472-1972
Titre abrégé: J Endocr Soc
Pays: United States
ID NLM: 101697997

Informations de publication

Date de publication:
01 Jun 2021
Historique:
received: 08 01 2021
entrez: 31 5 2021
pubmed: 1 6 2021
medline: 1 6 2021
Statut: epublish

Résumé

Activation of the vasopressin system plays a key role for the maintenance of osmotic, cardiovascular, and stress hormone homeostasis during disease. We investigated levels of copeptin, the C-terminal segment of the vasopressin prohormone, that mirrors the production rate of vasopressin in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We measured levels of copeptin on admission and after days 3/4, 5/6, and 7/8 in 74 consecutive hospitalized adult COVID-19 patients and compared its prognostic accuracy to that of patients with community-acquired pneumonia (n = 876) and acute or chronic bronchitis (n = 371) from a previous study by means of logistic regression analysis. The primary endpoint was all-cause 30-day mortality. Median admission copeptin levels in COVID-19 patients were almost 4-fold higher in nonsurvivors compared with survivors (49.4 pmol/L [iterquartile range (IQR) 24.9-68.9 pmol/L] vs 13.5 pmol/L [IQR 7.0-26.7 pmol/L]), resulting in an age- and gender-adjusted odds ratio of 7.0 (95% confidence interval [CI] 1.2-40.3), A pronounced activation of the vasopressin system in COVID-19 patients is associated with an adverse clinical course in COVID-19 patients. This finding, however, is not unique to COVID-19 but similar to other types of respiratory infections.

Sections du résumé

BACKGROUND BACKGROUND
Activation of the vasopressin system plays a key role for the maintenance of osmotic, cardiovascular, and stress hormone homeostasis during disease. We investigated levels of copeptin, the C-terminal segment of the vasopressin prohormone, that mirrors the production rate of vasopressin in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
METHODS METHODS
We measured levels of copeptin on admission and after days 3/4, 5/6, and 7/8 in 74 consecutive hospitalized adult COVID-19 patients and compared its prognostic accuracy to that of patients with community-acquired pneumonia (n = 876) and acute or chronic bronchitis (n = 371) from a previous study by means of logistic regression analysis. The primary endpoint was all-cause 30-day mortality.
RESULTS RESULTS
Median admission copeptin levels in COVID-19 patients were almost 4-fold higher in nonsurvivors compared with survivors (49.4 pmol/L [iterquartile range (IQR) 24.9-68.9 pmol/L] vs 13.5 pmol/L [IQR 7.0-26.7 pmol/L]), resulting in an age- and gender-adjusted odds ratio of 7.0 (95% confidence interval [CI] 1.2-40.3),
CONCLUSIONS CONCLUSIONS
A pronounced activation of the vasopressin system in COVID-19 patients is associated with an adverse clinical course in COVID-19 patients. This finding, however, is not unique to COVID-19 but similar to other types of respiratory infections.

Identifiants

pubmed: 34056499
doi: 10.1210/jendso/bvab045
pii: bvab045
pmc: PMC7989362
doi:

Types de publication

Journal Article

Langues

eng

Pagination

bvab045

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society.

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Auteurs

Claudia Gregoriano (C)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Alexandra Molitor (A)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Ellen Haag (E)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Alexander Kutz (A)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Daniel Koch (D)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Sebastian Haubitz (S)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.
Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Anna Conen (A)

Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, 5001 Aarau, Switzerland.
Medical Faculty, University of Basel, 4056‌ Basel, Switzerland.

Luca Bernasconi (L)

Institute of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Angelika Hammerer-Lercher (A)

Institute of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Christoph A Fux (CA)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.
Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, 5001 Aarau, Switzerland.

Beat Mueller (B)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.
Medical Faculty, University of Basel, 4056‌ Basel, Switzerland.

Philipp Schuetz (P)

Medical University Department of Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland.
Medical Faculty, University of Basel, 4056‌ Basel, Switzerland.

Classifications MeSH