Biomarker Evaluation for Prognostic Stratification of Patients with Covid-19: the Added Value of Quantitative Chest Ct

Abstract

Aim: Pulmonary disease burden and biomarkers are possible predictors of outcomes in patients with COVID-19 and provide complementary information. In this study, the prognostic value of adding quantitative chest computed tomography (CT) to a multiple biomarker approach was evaluated among 148 hospitalized patients with confirmed COVID-19. Materials & methods: Patients admitted between March and July 2020 who were submitted to chest CT and biomarker measurement (troponin I, D-dimer and C-reactive protein) were retrospectively analyzed. Biomarker and tomographic data were compared and associated with death and intensive care unit admission. Results: The number of elevated biomarkers was significantly associated with greater opacification percentages, lower lung volumes and higher death and intensive care unit admission rates. Total lung volume <3.0 l provided further stratification for mortality when combined with biomarker evaluation. Conclusion: Adding automated CT data to a multiple biomarker approach may provide a simple strategy for enhancing risk stratification of patients with COVID-19.

Troponin elevation on admission and mortality after hospital discharge among patients with COVID-19

“…Troponin values on admission could also perform as an indirect marker of non-cardiovascular damage during the disease's inflammatory cascade. Previous studies have demonstrated an association between higher troponin levels, greater total pulmonary opacification percentages, and lower lung volumes in hospitalized patients with COVID-19 11 . In the current study, those with hs-TnI elevation also presented with significantly greater lung involvement on computed tomography.…”