During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the Emergency Departments have been overrun with suspicious COVID-19 patients, creating a pressing need to optimize resources through risk stratification already at the triage level.

Mid-regional proadrenomedullin (MR-proADM), a more stable fragment of the rapidly degrading active adrenomedullin (ADM) peptide, has been proven a promising biomarker effective in predicting severity and long-term adverse outcomes in pneumonia.

Interestingly, when the microcirculatory integrity is deteriorated causing the capillary leak, an alteration of the endothelium barrier function can occur, as during sepsis.

It has been demonstrated that in these conditions MR-proADM plasma concentrations tend to increase.

Accordingly, Hupf et al. have recently reported high adrenomedullin RNA blood expression in patients with severe COVID-19 disease.

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