Cardiac Biomarker Abnormalities Are Closely Related to Prognosis in Patients with COVID-19

Int Heart J. 2021;62(1):148-152. doi: 10.1536/ihj.20-180.

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is erupting and spreading globally. Cardiovascular complications secondary to the infection have caught notice. This study aims to delineate the relationship of cardiac biomarkers and outcomes in severe cases of corona virus disease 2019 (COVID-19). One hundred forty-eight critically ill adult patients with COVID-19 were enrolled. From these patients, the demographic data, symptoms, cardiac biomarkers, treatments, and clinical outcomes were collected. Data were compared between survivors and non-survivors. Four patients in the non-survivor group were selected, and their cardiac biomarkers were collected and analyzed. Among the 148 patients, the incidence of cardiovascular complications was 19 (12.8%). Five of them were survivors (5.2%), and 14 of them were non-survivors (26.9%). Compared with the survivors, the non-survivors had higher levels of high-sensitivity cardiac troponin I, creatine kinase isoenzyme-MB, myoglobin, and N-terminal pro-brain natriuretic peptide (P < 0.05). The occurrence of cardiovascular events began at 11-15 days after the onset of the disease and reached a peak at 14-20 days. COVID-19 not only is a respiratory disease but also causes damage to the cardiovascular system. Cardiac biomarkers have the potential for early warning and prognostic evaluation in patients with COVID-19. It is recommended that cardiac biomarker monitoring in patients with COVID-19 should be initiated at least from the 11th day of the disease course.

Keywords: Cardiovascular complication; Hs-cTnI; Nt-proBNP; SARS-CoV-2.

MeSH terms

  • Adult
  • Aged
  • Atrial Natriuretic Factor / metabolism
  • Biomarkers / metabolism*
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / virology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / metabolism*
  • Case-Control Studies
  • China / epidemiology
  • Creatine Kinase, MB Form / metabolism
  • Critical Illness / mortality
  • Critical Illness / nursing
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Protein Precursors / metabolism
  • SARS-CoV-2 / genetics
  • Survival Rate
  • Survivors / statistics & numerical data
  • Troponin I / metabolism

Substances

  • Biomarkers
  • N-terminal proatrial natriuretic peptide
  • Protein Precursors
  • Troponin I
  • Atrial Natriuretic Factor
  • Creatine Kinase, MB Form