Correlation of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) with radiographic features of congestion in chest CT scan of patients with COVID-19

Naghmeh Ziaie; Seyed Mohammad Reza Tabatabaie; Khadijeh Ezoji; Ali Bijani; Simin Mouodi

doi:10.1186/s43044-023-00390-1

Correlation of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) with radiographic features of congestion in chest CT scan of patients with COVID-19

Egypt Heart J. 2023 Jul 13;75(1):59. doi: 10.1186/s43044-023-00390-1.

Authors

Naghmeh Ziaie¹, Seyed Mohammad Reza Tabatabaie², Khadijeh Ezoji³, Ali Bijani³, Simin Mouodi⁴

Affiliations

¹ Department of Cardiology, Babol University of Medical Sciences, Babol, Iran.
² Department of Radiology, Babol University of Medical Sciences, Babol, Iran.
³ Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
⁴ Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. dr.mouodi@gmail.com.

Abstract

Background: Given the importance of chest computed tomography (CT) to differentiate congestion from COVID-19 pneumonia, and considering the association of chest CT findings with cardiac biomarkers in patients with concomitant COVID-19 and heart failure, this study was conducted to identify the correlation between plasma NT-proBNP level and radiographic features of congestion in patients with COVID-19. This retrospective cohort research was carried out on adult hospitalized patients with COVID-19 and the plasma concentration of NT-proBNP was measured. The most important findings in chest CT have been considered to differentiate COVID-19 pneumonia from congestion. The study population was divided into two groups based on the presence of these imaging characteristics.

Results: Totally, 180 patients with a mean age of 59.6 ± 14.6 years were included in the research. The radiographic findings related to congestion have been found in chest CT of 107 (59.4%) patients. Mean plasma concentration of NT-proBNP in patients with and without radiographic features of congestion was 9886.5 ± 12,676 and 2079.9 ± 4209.3 pg/mL, respectively (p < 0.001). The area under the curve of plasma levels of NT-proBNP for identification of patients with COVID-19 who had pulmonary vein enlargement in chest CT was 0.765 (95% CI 0.688-0.842) and 0.731 (95% CI 0.648-0.813) for the individuals who had interlobar fissure thickening (p < 0.001).

Conclusions: The diagnostic accuracy of plasma NT-proBNP and its positive correlation with radiographic features of congestion in chest CT scan of patients with COVID-19 can be helpful for administering appropriate medications to prevent blood volume overload.

Keywords: Biomarkers; Congestion; Coronavirus infections; NT-proBNP.