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Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19

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机构: [1]Wuhan Univ, Zhongnan Hosp, Dept Cardiol, Wuhan, Peoples R China [2]Wuhan Univ, Zhongnan Hosp, Med Sci Res Ctr, Wuhan, Peoples R China [3]Wuhan Univ, Zhongnan Hosp, Dept Hepatobiliary & Pancreat Surg, Wuhan, Peoples R China [4]Wuhan Univ, Basic Med Sch, Wuhan, Peoples R China [5]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China [6]Wuhan Univ, Dept Neonatol, Renmin Hosp, Wuhan, Peoples R China [7]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China [8]Univ Ottawa Heart Inst, Dept Med, Div Cardiol, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada [9]Cent South Univ, Xiangya Hosp 3, Dept Cardiol, Changsha, Peoples R China [10]Queen Mary Univ London, William Harvey Res Inst, Ctr Clin Pharmacol, London, England [11]Thomas Jefferson Univ, Dept Emergency Med, Philadelphia, PA 19107 USA [12]Univ Glasgow, BHF Glasgow Cardiovasc Res Ctr, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland [13]Univ Calif Los Angeles, David Geffen Sch Med, Dept Anesthesiol, Cardiovasc Res Labs, Los Angeles, CA 90095 USA [14]Ezhou Cent Hosp, Dept Gen Surg, Wuhan, Peoples R China [15]Huanggang Cent Hosp, Dept Gen Surg, Wuhan, Peoples R China [16]Wuhan Univ, Dept Urol, Wuhan Hosp 3, Wuhan, Peoples R China [17]Wuhan Univ, Dept Gastroenterol, Wuhan Hosp 3, Wuhan, Peoples R China [18]Wuhan Univ, Tongren Hosp, Wuhan, Peoples R China [19]Wuhan Seventh Hosp, Wuhan, Peoples R China [20]Huazhong Univ Sci & Technol, Tongji Med Coll, Cent Hosp Wuhan, Dept Cardiol, Wuhan, Peoples R China [21]Wuhan Hosp Tradit Chinese & Western Med, Wuhan Hosp 1, Dept Neurol, Wuhan, Hubei, Peoples R China
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关键词: biomarkers heart diseases heart injuries mortality prognosis

摘要:
The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60-11.03]P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50-7.47]P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33-7.09]P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18-6.36]P<0.001), and CK was 3.56 ([95% CI, 2.53-5.02]P<0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%-50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19-associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.

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出版当年[2019]版:
大类 | 1 区 医学
小类 | 2 区 外周血管病
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 外周血管病
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出版当年[2018]版:
Q1 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

第一作者:
第一作者机构: [1]Wuhan Univ, Zhongnan Hosp, Dept Cardiol, Wuhan, Peoples R China [5]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China [7]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China
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通讯作者:
通讯机构: [2]Wuhan Univ, Zhongnan Hosp, Med Sci Res Ctr, Wuhan, Peoples R China [4]Wuhan Univ, Basic Med Sch, Wuhan, Peoples R China [5]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China [7]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China [8]Univ Ottawa Heart Inst, Dept Med, Div Cardiol, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada [13]Univ Calif Los Angeles, David Geffen Sch Med, Dept Anesthesiol, Cardiovasc Res Labs, Los Angeles, CA 90095 USA [*1]Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario K1Y 4W7, Canada [*2]Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, CA [*3]Department of Cardiology, Zhongnan Hospital of Wuhan University, Institute of Model Animal of Wuhan University, 169 Donghu Rd, Wuhan 430071, China
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