Purpose: The aim of our study was to analyse the short-term prognostic value of different biomarkers in patients with COVID-19. Methods: We included patients admitted to emergency department with COVID-19 and available concentrations of cardiac troponin I (cTnI), D-dimer, C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients were classified for each biomarker into two groups (low vs. high concentrations) according to their best cut-off point, and 30-day all-cause death was evaluated. Results: After multivariate adjustment, cTnI !21 ng/L, D-dimer !1112 ng/mL, CRP !10 mg/dL and LDH !334 U/L at admission were associated with an increased risk of 30-day all-cause death (hazard ratio (HR) 4.30; 95% CI 1.74-10.58; p ¼ 0.002; HR 3.35; 95% CI 1.58-7.13; p ¼ 0.002; HR 2.25; 95% CI 1.13-4.50; p ¼ 0.021; HR 2.00; 95% CI 1.04-3.84; p ¼ 0.039, respectively). The area under the curve for cTnI was 0.825 (95% CI 0.759-0.892) and, in comparison, was significantly better than CRP (0.685; 95% CI 0.600-0.770; p ¼ 0.009) and LDH (0.643; 95% CI 0.534-0.753; p ¼ 0.006) but non-significantly better than D-dimer (0.756; 95% CI 0.674-0.837; p ¼ 0.115). Conclusions: In patients with COVID-19, increased concentrations of cTnI, D-dimer, CRP and LDH are associated with short-term mortality. Of these, cTnI provides better mortality risk prediction. However, differences with D-dimer were non-significant.
The results of this study suggest that OSA has a protective effect in the context of myocardial infarction and that patients with OSA may experience less severe myocardial injury. The possible role of OSA in cardioprotection should be explored in future studies.
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