Endogenous Catecholamine Release in COVID-19 Related Acute Respiratory Distress Syndrome: Link between Enhanced Sympathetic Stimulation, Cardiac Dysfunction and Outcome.
Valentino DammassaMarta VoltiniCostanza Natalia Julia ColomboGilda Maria SianoClaudia Lo CocoVittoria RizzoFrancesco CorradiFrancesco MojoliGuido TavazziPublished in: Journal of clinical medicine (2023)
The aim of this study was to measure the serum levels of catecholamines in patients admitted to intensive care unit (ICU) with COVID-19-related acute respiratory distress syndrome (ARDS) and describe their relation with clinical, inflammatory and echocardiographic parameters. Serum levels of endogenous catecholamines (norepinephrine, epinephrine and dopamine) were measured at ICU admission. We enrolled 71 patients consecutively admitted to ICU due to moderate to severe ARDS. 11 patients (15.5%) died during the admission in ICU. Serum levels of endogenous catecholamines were significantly elevated. Norepinephrine levels were higher in those with RV and LV systolic dysfunction, higher CRP, and higher IL-6. Patients with higher mortality rate were those with norepinephrine values ≥ 3124 ng/mL, CRP ≥ 17.2 mg/dL and IL-6 ≥ 102 pg/mL. Univariable analysis by Cox proportional hazards regression modelling showed that norepinephrine, IL-6 and CRP had the highest risk of acute mortality. Multivariable analysis showed that only norepinephrine and IL-6 retained in the model. Marked increase of serum catecholamine levels is present during acute phase of critically ill COVID-19 and it is associated with inflammatory and clinical parameters.
Keyphrases
- acute respiratory distress syndrome
- mechanical ventilation
- intensive care unit
- extracorporeal membrane oxygenation
- coronavirus disease
- end stage renal disease
- ejection fraction
- respiratory failure
- sars cov
- oxidative stress
- left ventricular
- newly diagnosed
- emergency department
- heart failure
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- type diabetes
- cardiovascular disease
- pulmonary hypertension
- risk factors
- mitral valve
- patient reported outcomes
- uric acid