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Bleilevens, Christian; Soppert, Josefin; Hoffmann, Adrian; Breuer, Thomas; Bernhagen, Jürgen; Martin, Lukas; Stiehler, Lara; Marx, Gernot; Dreher, Michael; Stoppe, Christian und Simon, Tim-Philipp (2021): Macrophage Migration Inhibitory Factor (MIF) Plasma Concentration in Critically Ill COVID-19 Patients: A Prospective Observational Study. In: Diagnostics, Bd. 11, Nr. 2, 332 [PDF, 7MB]

Abstract

Mortality in critically ill coronavirus disease 2019 (COVID-19) patients is high and pharmacological treatment strategies remain limited. Early-stage predictive biomarkers are needed to identify patients with a high risk of severe clinical courses and to stratify treatment strategies. Macrophage migration inhibitory factor (MIF) was previously described as a potential predictor for the outcome of critically ill patients and for acute respiratory distress syndrome (ARDS), a hallmark of severe COVID-19 disease. This prospective observational study evaluates the predictive potential of MIF for the clinical outcome after severe COVID-19 infection. Plasma MIF concentrations were measured in 36 mechanically ventilated COVID-19 patients over three days after intensive care unit (ICU) admission. Increased compared to decreased MIF was significantly associated with aggravated organ function and a significantly lower 28-day survival (sequential organ failure assessment (SOFA) score;8.2 +/- 4.5 to 14.3 +/- 3, p = 0.009 vs. 8.9 +/- 1.9 to 12 +/- 2, p = 0.296;survival: 56% vs. 93%;p = 0.003). Arterial hypertension was the predominant comorbidity in 85% of patients with increasing MIF concentrations (vs. decreasing MIF: 39%;p = 0.015). Without reaching significance, more patients with decreasing MIF were able to improve their ARDS status (p = 0.142). The identified association between an early MIF response, aggravation of organ function and 28-day survival may open future perspectives for biomarker-based diagnostic approaches for ICU management of COVID-19 patients.

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