The diagnostic and prognostic role of myocardial injury biomarkers in hospitalized patients with COVID-19
Open accessAbstract
Objective The aim of this study was to systematically and comprehensively evaluate the diagnostic and prognostic value of myocardial injury biomarkers in COVID-19 patients. Methods This is a retrospective cohort study of confirmed COVID-19 patients that were admitted to the Renmin Hospital of Wuhan University from January 30, 2020 to February 15, 2020. Results Receiver operating characteristic (ROC) curve analysis demonstrated that cTnI-ultra had the highest area under the curve (AUC) at 0.855, with a sensitivity of 67.3% and a specificity of 88.7% for the prediction of in-hospital mortality. Patients with higher troponin I-ultra (cTnI-ultra), creatinine kinase-myocardial band (CK-MB), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were associated with higher mortality, compared to those who lower levels. The multivariable cox regression indicated that age (hazard ratio (HR) 3.450, 95% confidence interval (CI) 1.627-7.314, P = 0.001), coronary heart disease (HR 1.855, 95% CI 1.006-3.421; P = 0.048), elevated cTnI-ultra (HR 3.083, 95% CI 1.616-5.883, P = 0.001), elevated CK-MB (HR 2.907, 95% CI 1.233-6.854; P = 0.015), and elevated NT-proBNP (HR 5.776, 95% CI 2.272-14.682; P < 0.001) were associated with in-hospital mortality. Conclusions cTnI-ultra might be the best predictor of in-hospital mortality among myocardial injury biomarkers. Elevated cTnI-ultra, CK-MB, and NT-proBNP were independent biomarkers of the mortality in COVID-19 patients.
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In patients with severe COVID-19, elevated biomarkers of cardiac damage that predict heart failure including troponins and NT-proBNP were strongly and independently associated with in-hospital mortality.
“In patients with severe COVID-19, elevated biomarkers of cardiac damage that predict heart failure including troponins and NT-proBNP (N-terminal pro-B-type natriuretic peptide) were strongly and independently associated with in-hospital mortality.”
From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [70]
The Results (Association of myocardial injury biomarkers with in-hospital mortality; page unavailable) report that elevated cTnI-ultra and NT-proBNP were independent predictors of in-hospital mortality, with multivariate hazard ratios of 3.083 and 5.776. The study enrolled hospitalized COVID-19 patients, not specifically patients with severe disease, and our copy does not establish that these biomarkers predict heart failure. (LLM, conf=0.88)
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- Authors
- Deng, P., Ke, Z., Ying, B., Qiao, B., & Yuan, L.
- Affiliations
- Hubei University of Medicine (CN)
- Sichuan University (CN)
- Renmin Hospital of Wuhan University (CN)
- Corresponding author
- Yuan, Leyong
- Venue
- Clinica Chimica Acta
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 510
- Pages
- 186-190
- ISSN
- 0009-8981 (ISSN-L)
- PMC
- PMC7363604
- OpenAlex
- W3042336050
- Cited by
- 47
- References
- 21
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 11 · 2022: 6 · 2021: 22 · 2020: 2
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinica Chimica Acta (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hubei University of Medicine (2017QDJZR03)
- National Natural Science Foundation of China (81802090, 20Y03, 2020XGFYZR17)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
- Keywords
- COVID-19 pandemic, myocardial injury, cardiac biomarkers, troponin I, creatine kinase-MB, NT-proBNP, in-hospital mortality, prognostic factors, diagnostic biomarkers, hospitalized patients
- MeSH terms
- COVID-19, Aged, Female, Heart Injuries, Hospitalization, Humans, Male, Middle Aged, Pneumonia, Viral, Retrospective Studies, ROC Curve, Cohort Studies, Biomarkers, Hospital Mortality, Coronavirus Infections, Pandemics
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