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

Abstract

Background: 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 is a common condition among the hospitalized patients with COVID-19. However, whether N terminal pro B type natriuretic peptide (NT-proBNP) predicted outcome of severe COVID-19 patients was unknown. Methods: The study initially enrolled 102 patients with severe COVID-19 from a continuous sample. After screening out the ineligible cases, 54 patients were analyzed in this study. The primary outcome was in-hospital death defined as the case fatality rate. Research information and following-up data were obtained from their medical records.Results: The best cut-off value of NT-proBNP for predicting in-hospital death was 88.64 pg/mL with the sensitivity for 100% and the specificity for 66.67%. Patients with high NT-proBNP values (> 88.64 pg/mL) had a significantly increased risk of death during the days of following-up compared with those with low values (≤88.64 pg/mL). After adjustment for potential risk factors, NT-proBNP was independently correlated with in-hospital death. Conclusion: NT-proBNP might be an independent risk factor for in-hospital death in patients with severe COVID-19.

Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis

“…In the present meta-analysis, several indicators of cardiovascular injury, such as hs-cTnI, NT-proBNP, CK-MB and myoglobin, were signi cantly higher in patients in nonsurvivor group than in those in the survivor group. Increased hs-cTnI and NT-proBNP among COVID-19 patients have been identi ed as independent risk factors for mortality even after adjustment for age and other confounding factors [9,10]. Therefore, we suggest frequent measurement of hs-cTnI and NT-proBNP should be required in the management of COVID-19, especially for patients with preexisting cardio-cerebrovascular disease.…”

“…Adjusted data regarding mortality due to COVID-19 infection were available in 16 studies [4,5,7,9,10,12,[17][18][19]21,26,28,29,31,37,38] (Table 3). A multivariate Cox regression model was used in ten studies, and a multivariate logistic regression model was applied in six studies.…”

“…In two studies, the symptom of dyspnea was correlated with a greater risk of death [4,31]. Decreased PLTs [26,31] and increased WBCs (≥10×10 9 /L) [17,31], NEUs (≥6 ×10 9 /L) [31], neutrophil-to-lymphocyte ratio [19], PCT (>0.5 ng/mL) [4], CRP (≥27.8 mg/L) [31], AST (>40 U/L) [4], hs-cTnI (≥0.05 ng/mL) [9], Cr [5,7], BUN [7], NT-proBNP [10] and D-dimer [26,37,38] were identi ed as risk factors for mortality. Moreover, CD3+ CD8+ T cells ≤75/μL [9] and the presence of proteinuria and hematuria [7] were also correlated with an increased mortality rate.…”

Journal watch

“…Interestingly, another paper, published in Respiratory Research, 2 showed that NT-proBNP might be an independent risk factor for in-hospital death in patients with severe COVID-19. The best cut-off value for NT-proBNP for predicting in-hospital death was 88.64pg/ml, with a sensitivity of 100% and a specificity of 66.7%.…”

The role of natriuretic peptide estimation in severe COVID-19

“…Interestingly, on serial monitoring, the NT-pro BNP levels increased significantly during hospitalization in non-survivors, while the levels remained static in patients who survived, thus highlighting the importance of natriuretic peptides for prognostication in these patients [3]. Furthermore, In a recently published small observational study, NT-pro BNP was demonstrated as an independent risk factor of inhospital death in patients with severe COVID-19 [6].…”