Prognostic value of NT-proBNP in patients with severe COVID-19

Abstract

The outbreak of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China has been declared a public health emergency of international concern. The cardiac injury was dominate in the process. However, whether N terminal pro B type natriuretic peptide (NT-proBNP) predicted outcome of COVID-19 patients was unknown. The study initially enrolled 102 patients with severe COVID-19 pneumonia from a continuous sample. After screening out the ineligible cases, 54 patients were analyzed in this study. Results found that patients with higher NT-proBNP (above 88.64 pg/mL) level had more risks of inhospital death. After adjusting for potential cofounders in separate modes, NT-proBNP presented as an independent risk factor of in-hospital death in patients with severe COVID-19. : medRxiv preprint Figure 1. The NT-proBNP for in-hospital death of coronavirus disease 2019 (COVID-19) by receiver operating characteristic (ROC) curves. The area under the curve (AUC) of NT-proBNP was 0.909. The best cutoff of NT-proBNP for prediction in-hospital death was 88.64 pg/mL with the sensitivity of 100% and the specificity of 66.67%. 95%CI, 95% confidence interval. All rights reserved. No reuse allowed without permission.the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10. 1101 Figure 2. Kaplan-Meier plots showing the cumulative survival rate of COVID-19 patients who were stratified into two groups according to plasma NT-proBNP cutoff point at baseline (Dotted line, NT-proBNP ≤88.64 pg/ml, n=24; Solid line, NT-proBNP >88.64 pg/ml, n=30; log-rank test for trend, P<0.001).All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

Relationship Between IL-6 and COVID-19: to Be Considered During Treatment

“…Studies have also reported that they have broad-spectrum antiviral activity, particularly against SARS, and have recently been included in the Chinese and Italian guidelines for the treatment of COVID-19. Chloroquine increases the endosomal pH necessary for viral cell fusion and it also glycosylates ACE2 receptors and inhibits viral entry into cells [ 13 , 14 , 23 ]. On the other hand, Baricitinib is an another drug used to treat RA.…”

Scientific hypothesis and rational pharmacological for the use of sacubitril/valsartan in cardiac damage caused by COVID-19

“…In particular, cytokine storm [55] , [56] could probably play an important role in cardiac damage [57] and the increase of NT-proBNP. In addition, RAS overactivation with reduced ACE-2 concentration, as evidenced in the most severe stages of COVID-19 infection, may lead to increased synthesis of Ang II with proinflammatory and profibrotic effects (mediated by AT-1 receptors) that facilitates the secretion of NT-proBNP [58] , [59] . Pending well-structured and thorough studies, to assess whether the NT-proBNP marker can be a useful diagnostic test to assess the severity of COVID-19 infection, all the considerations expressed suggest a therapeutic pharmacological solution with the action of increasing the concentration of circulating natriuretic peptides, decrease the concentration of NT-proBNP, increase RAS via ACE-2 axis with increased synthesis of Ang 1-7 and Ang 1-9 with antifibrotic and anti-inflammatory effects, and decrease the effects of Ang II on the AT-1 receptor [60] , [61] , [62] , [63]…”

Blood parameters measured on admission as predictors of outcome for COVID-19; a prospective UK cohort study

“…As a result there has been a focus on biomarkers that rise in other similar conditions such as ferritin, lactate dehydrogenase (LDH), IL-6, and soluble urokinase plasminogen activator receptor (suPAR) (12)(13)(14)(15). A rise in cardiovascular events and coagulopathies has also been seen in patients with COVID-19 pneumonia so biomarkers such as troponin, NT-pro BNP, fibrinogen and D-dimer have been studied (16)(17)(18)(19). Given that mortality from COVID-19 increases with age and frailty, biomarkers of frailty have been shown to be related to worse outcomes (albumin, eGFR) (2,20).…”