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Urinary peptide signatures were reported to be predictive of death in SARS\u2010CoV\u20102 and chronic kidney disease. Such signatures were composed for 68% of collagen fragments. In this study, we examined whether urinary collagen peptides, potentially representing organ fibrosis, could predict mortality in patients with critical and non\u2010critical conditions. Urinary proteomic data from 1012 patients with follow\u2010up information from the CRIT\u2010COV\u2010U study were investigated for the association of collagen peptides with short\u2010term mortality. Independent datasets from 9193 patients were used for validation, including 1719 patients sampled at intensive care unit (ICU) admission and 7474 patients with other diseases (outside the ICU). A total of 607 collagen peptides were significantly associated with mortality. A classifier based on 210 collagen peptides (COL210) predicting mortality was developed and validated in patients in the ICU (ICU\n                    <jats:sub>HR<\/jats:sub>\n                    : 2.64; 95% CI:1.71\u20104.10;\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.001) and outside the ICU (Non\u2010ICU\n                    <jats:sub>HR<\/jats:sub>\n                    : 2.16 95% CI: 1.47\u20133.17;\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.001), showing strong associations to mortality regardless underlying conditions. This study demonstrates a link between the presence of ECM fragments in urine, specifically collagens, and increased mortality risk. Such a non\u2010invasive collagen\u2010based predictor of mortality may serve as a basis for proteomics\u2010guided targeted intervention.\n                  <\/jats:p>","DOI":"10.1002\/pmic.70131","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:53:02Z","timestamp":1775728382000},"page":"98-110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Urinary Collagen Peptides Predict Mortality"],"prefix":"10.1002","volume":"26","author":[{"given":"Maria","family":"Frantzi","sequence":"first","affiliation":[{"name":"Department of Biomarker Research Mosaiques Diagnostics GmbH  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Nephrology and Hypertension) Medical University of Innsbruck  Innsbruck 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Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost P.","family":"Schanstra","sequence":"additional","affiliation":[{"name":"Institut National de La Sant\u00e9 et De La Recherche M\u00e9dicale (INSERM), UMR 1297 Institute of Metabolic and Cardiovascular Disease  Toulouse France"},{"name":"University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Catanese","sequence":"additional","affiliation":[{"name":"Department of Nephrology Angiology and Rheumatology, Klinikum Bayreuth GmbH  Bayreuth Germany"},{"name":"Department of Nephrology Medizincampus Oberfranken Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg  Erlangen Germany"},{"name":"Kuratorium for Dialysis and Transplantation (KfH)  Bayreuth Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Wendt","sequence":"additional","affiliation":[{"name":"Department of Nephrology St. Georg Klinikum Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Rupprecht","sequence":"additional","affiliation":[{"name":"Department of Nephrology Angiology and Rheumatology, Klinikum Bayreuth GmbH  Bayreuth Germany"},{"name":"Department of Nephrology Medizincampus Oberfranken Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg  Erlangen Germany"},{"name":"Kuratorium for Dialysis and Transplantation (KfH)  Bayreuth Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan A.","family":"Staessen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Institute of Hypertension Shanghai Key Laboratory of Hypertension National Research Centre For Translational Medicine State Key Laboratory of Medical Genomics Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Non\u2010Profit Research Institute Alliance for the Promotion 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