Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients
Open Access
- 10 May 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Scientific Reports
- Vol. 11 (1), 1-12
- https://doi.org/10.1038/s41598-021-89180-w
Abstract
COVID-19 is a disease with a variable clinical course ranging from mild symptoms to critical illness, organ failure, and death. Prospective biomarkers may help to predict the severity of an individual’s clinical course and mortality risk. We analyzed asymmetric (ADMA) and symmetric dimethylarginine (SDMA) in blood samples from 31 patients hospitalized for COVID-19. We calculated associations of ADMA and SDMA with mortality and organ failure, and we developed a predictive algorithm based upon these biomarkers to predict mortality risk. Nine patients (29%) experienced in-hospital death. SDMA and ADMA serum concentrations were significantly higher at admission in COVID-19 patients who died than in survivors. Cut-offs of 0.90 µmol/L for SDMA (AUC, 0.904, p = 0.0005) and 0.66 µmol/L for ADMA (AUC, 0.874, p = 0.0013) were found in ROC analyses to best discriminate both subgroups of patients. Hazard ratio for in-hospital mortality was 12.2 (95% CI: 2.2–31.2) for SDMA and 6.3 (1.1–14.7) for ADMA above cut-off. Sequential analysis of both biomarkers allowed discriminating a high-risk group (87.5% mortality) from an intermediate-risk group (25% mortality) and a low-risk group (0% mortality). Elevated circulating concentrations of SDMA and ADMA may help to better identify COVID-19 patients with a high risk of in-hospital mortality.Funding Information
- Bundesministerium für Bildung und Forschung (01DN17046, 01DN17046)
- Georg und Jürgen Rickertsen Stiftung
- Joachim Herz Stiftung
- Deutsche Forschungsgemeinschaft (SFB TRR219 (M-03; M-05))
This publication has 47 references indexed in Scilit:
- Acute Respiratory Distress SyndromeJAMA, 2012
- Symmetric dimethylarginine predicts all-cause mortality following ischemic strokeAtherosclerosis, 2010
- Asymmetric dimethylarginine (ADMA) as a prospective marker of cardiovascular disease and mortality—An update on patient populations with a wide range of cardiovascular riskPharmacological Research, 2009
- Plasma Asymmetric Dimethylarginine and Incidence of Cardiovascular Disease and Death in the CommunityJournal of the American College of Cardiology, 2009
- High-throughput liquid chromatographic-tandem mass spectrometric determination of arginine and dimethylated arginine derivatives in human and mouse plasmaJournal of Chromatography B, 2007
- Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injuryCritical Care, 2007
- Determination of a reference value for NG, NG‐dimethyl‐L‐arginine in 500 subjectsEuropean Journal of Clinical Investigation, 2005
- Asymmetric Dimethylarginine and the Risk of Cardiovascular Events and Death in Patients With Coronary Artery DiseaseCirculation Research, 2005
- Asymmetrical dimethylarginine (ADMA) in critically ill patients: high plasma ADMA concentration is an independent risk factor of ICU mortalityClinical Nutrition, 2003
- S -nitrosylation of dimethylarginine dimethylaminohydrolase regulates enzyme activity: Further interactions between nitric oxide synthase and dimethylarginine dimethylaminohydrolaseProceedings of the National Academy of Sciences of the United States of America, 2002