Meta-analysis of cardiac markers for predictive factors on severity and mortality of COVID-19

Wungu, Citrawati Dyah Kencono; Khaerunnisa, Siti; Putri, Eka Arum Cahyaning; Hidayati, Hanik Badriyah; Qurnianingsih, Ema; Lukitasari, Lina; Humairah, Ira; Soetjipto,

doi:10.1016/j.ijid.2021.03.008

Cited by 33 publications

(36 citation statements)

References 65 publications

(47 reference statements)

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“…In the current study, laboratory parameters indicating increased risk of severe COVID-19 such as N/L ratio and CRP were identical in both groups, but D-dimer and IL-6 levels were higher on admission in the second wave. It has previously been suggested by Wungu et al, in a meta-analysis comparing cardiac markers as predictive factors in COVID-19 infection that the D-dimer level was the best predictor of severity and mortality [13]. IL-6 levels were also shown to be significantly elevated in patients with severe disease relative to those with less severe disease.…”

Section: Discussionmentioning

confidence: 81%

COVID-19: A comparative study of severity of patients hospitalized during the first and the second wave in South Africa

Maslo

Messina²,

Laubscher

et al. 2021

Preprint

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Background South Africa has experienced two waves of COVID-19 infections, the second of which was inter alia attributed to the emergence of a novel SARS-CoV2 variant, 501Y.V2. This variant possibly has increased virulence and may be associated with increased mortality. The objective of this study was to determine if patients admitted in the second wave had more severe illness and higher mortality than those admitted in the first. Methods We analysed and compared the characteristics, biological severity markers, treatments, level of care and outcomes of patients hospitalised in a private hospital in the Eastern Cape Province, South Africa. Results Compared to the first wave, patients admitted in the second were older and less likely to have co-morbidities. In contrast, the D-dimer and interleukin-6 (IL-6) levels were significantly higher. Despite this, significantly less patients were admitted to ICU and/or were mechanically ventilated. The total length of hospital stay was identical in both groups. Whereas the overall mortality was not significantly higher during the second wave, the ICU mortality was. Those that died in the second wave were older than those in the first wave. Multivariable logistic regression showed that being admitted during the second wave was an independent risk factor for mortality. Conclusion This study appears to confirm previous reports that the 501Y.V2 variant is possibly more virulent as indicated by the higher levels of D-dimer and IL-6, the slight increase in mortality of hospitalised patients and the higher ICU mortality in the second wave.

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Section: Discussionmentioning

confidence: 81%

COVID-19: A comparative study of severity of patients hospitalized during the first and the second wave in South Africa

Maslo

Messina²,

Laubscher

et al. 2021

Preprint

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“… 135 In another recently published article, high concentrations of CK‐MP, procalcitonin, NT‐proBNP, BNP, troponin, and D‐dimers have been shown to predict severity and survival for patients with COVID‐19 as well. 136 Several other studies have confirmed the relationship between high troponin values and a worse prognosis in patients with COVID‐19 infection. 126 , 137 , 138 , 139 It is still not clear whether this relationship is due to a more severe form of COVID‐19 or to a more extensive cardiac damage or both.…”

Section: Covid‐19 Infection and Cardiac Biomarkersmentioning

confidence: 87%

Biomarkers in the management of acute heart failure: state of the art and role in COVID‐19 era

et al. 2021

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Acute heart failure (AHF) affects millions of people worldwide, and it is a potentially life‐threatening condition for which the cardiologist is more often brought into play. It is crucial to rapidly identify, among patients presenting with dyspnoea, those with AHF and to accurately stratify their risk, in order to define the appropriate setting of care, especially nowadays due to the coronavirus disease 2019 (COVID‐19) outbreak. Furthermore, with physical examination being limited by personal protective equipment, the use of new alternative diagnostic and prognostic tools could be of extreme importance. In this regard, usage of biomarkers, especially when combined (a multimarker approach) is beneficial for establishment of an accurate diagnosis, risk stratification and post‐discharge monitoring. This review highlights the use of both traditional biomarkers such as natriuretic peptides (NP) and troponin, and emerging biomarkers such as soluble suppression of tumourigenicity (sST2) and galectin‐3 (Gal‐3), from patients' emergency admission to discharge and follow‐up, to improve risk stratification and outcomes in terms of mortality and rehospitalization.

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“…BNP was recently described in the meta-analysis by Wungu et al [ 11 ] as a possible predictive marker for survival of COVID-19 patients. A significant difference between surviving and non-surviving patients was reported in our study as well, but BNP was eventually outperformed by NT-proBNP and HsTnI ROC curves.…”

Section: Discussionmentioning

confidence: 99%

“…NT-proBNP is currently known as an independent risk factor for in-hospital death of patients with severe COVID-19 [ 10 ]. B-type natriuretic peptide (BNP) was recently reported as a possible predictive marker for survival of COVID-19 patients [ 11 ]. HsTnI is significantly increased at admission in patients with severe COVID-19 compared to those affected by milder forms of COVID-19 [ 12 ], and has been recently described as a possible predictor of in-hospital mortality [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

B-Type Natriuretic Peptides and High-Sensitive Troponin I as COVID-19 Survival Factors: Which One Is the Best Performer?

Vargas

Palma

Savoia

et al. 2021

JCM

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Increased concentrations of B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (HsTnI) in COVID-19 patients have already been reported. The aim of this study is to evaluate which of these common markers of cardiac disease is the most useful predictor of fatal outcome in COVID-19 patients. One hundred and seventy-four patients affected with COVID-19 were recruited, and markers of cardiac disease and the clinical history of the patients were collected at admission in the infectious disease unit or intensive care unit. NT-proBNP, BNP and HsTnI values were higher in in-hospital non-surviving patients. Receiver operating characteristic (ROC) curve analysis of NT-proBNP, BNP and HsTnI was performed, with NT-proBNP (AUC = 0.951) and HsTnI (AUC = 0.947) being better performers (p = 0.01) than BNP (AUC = 0.777). Logistic regression was performed assessing the relation of HsTnI and NT-proBNP to fatal outcome adjusting for age and gender, with only NT-proBNP being significant. The population was then divided into two groups, one with higher NT-proBNP values at admission than the cut-off resulted from the ROC curve (511 ng/L) and a second one with lower values. The Kaplan–Meier analysis showed an absence of fatal outcome in the group of patients with NT-proBNP values lower than the cut-off (p < 0.001). NT-proBNP proved to be the best prognostic tool for fatal outcome among markers of cardiac disease in COVID-19 patients.

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Meta-analysis of cardiac markers for predictive factors on severity and mortality of COVID-19

Cited by 33 publications

References 65 publications

COVID-19: A comparative study of severity of patients hospitalized during the first and the second wave in South Africa

COVID-19: A comparative study of severity of patients hospitalized during the first and the second wave in South Africa

Biomarkers in the management of acute heart failure: state of the art and role in COVID‐19 era

B-Type Natriuretic Peptides and High-Sensitive Troponin I as COVID-19 Survival Factors: Which One Is the Best Performer?

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