The impact of daily troponin I and D-dimer serum levels on mortality in COVID-19 pneumonia patients

Stavileci, Berna; Ereren, Emrah; Ozdemir, Emrah; Özdemir, Bahar; Cengiz, Mahir; Enar, Rasim

doi:10.5830/cvja-2022-017

Cited by 3 publications

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“…[ 13 , 14 ] The primary mechanism of direct cardiac injury is due to the interaction between SARS-CoV-2 and cardiomyocytes. [ 13 , 14 ] Many studies show that high values of cardiac biomarkers such as troponin, [ 15 , 16 ] N-terminal pro-B type natriuretic peptide (NT pro-BNP), and creatine kinase myocardial band, [ 16 , 17 ] were associated with severe disease and higher mortality. [ 17 ] These patients were older, male, and have a history of cardiovascular disease (CVD).…”

Section: Discussionmentioning

confidence: 99%

The differences in troponin values among gender in COVID-19 patients

Stavileci

2023

Medicine

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The aim of this study is to investigate the differences on admission troponin values among gender in hospital outcomes and in the 2-year follow-up period in coronavirus disease (COVID-19) patients. Data of 826 patients with moderate-to-severe COVID-19 disease were analyzed retrospectively. All patients had nasal and oropharyngeal swab samples taken according to Ministry of Health guidelines on admission. Patients were divided into female (n = 438) and male (n = 388) groups and were follow-up for 2 years. Clinical events such as need for intensive care unit, respiratory failure, need for inotropic initiation, acute renal failure, cardiac injury, and in-hospital mortality were also recorded. The cumulative endpoints were determined as all-cause mortality, re-hospitalization, and stroke during the 2-year follow-up period. Also, factors affecting the cumulative endpoints were investigated. In clinical events and cumulative endpoints, the differences of troponin values between the gender were investigated and the factors causing cardiac injury were determined separately in men and women. Mean age (59.43 ± 19.15 vs 58.14 ± 16.66) and comorbidities were significantly higher in the female group. There were no differences between genders in terms of clinical events except respiratory failure, which was more frequent in the male group (P = .016). In-hospital survivor rate in the female group was 16 ± 2.5 days (95% confidence interval: 11.08–20.91), in the male group was 14 ± 0.92 days (95% confidence interval: 12.18–15.81) P = .008, while there were no differences between groups among in-hospital morality rates (P = .208). During the 2-year follow-up period cumulative endpoints were more in the male group (P < .05). Troponin value in female ≥ 93 pg/mL, in male ≥ 28 pg/mL was related with cardiac injury. All clinical events occur at lower troponin values in the male group. In both groups, independent risk factors for in-hospital mortality were troponin and the existence of fragmented QRS; for cumulative endpoints were respiratory failure, cardiac injury, and age. We observed that in COVID-19 disease, troponin value differs by gender. A lesser increase in troponin levels in men was indicative of cardiac injury. Even slight increases in troponin levels in men should alert clinicians for cardiac injury and other clinical events.

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Section: Discussionmentioning

confidence: 99%

The differences in troponin values among gender in COVID-19 patients

Stavileci

2023

Medicine

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Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

Wang

Liu

et al. 2023

BMC Infect Dis

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Background Although there is increasing understanding of the changes in the laboratory parameters of Coronavirus disease 2019 (COVID-19), the correlation between circulating Mid-regional Proadrenomedullin (MR-proADM) and mortality of patients with COVID-19 is not fully understood. In this study, we conducted a systematic review and meta-analysis to evaluate the prognostic value of MR-proADM in patients with COVID-19. Methods The PubMed, Embase, Web of Science, Cochrane Library, Wanfang, SinoMed and Chinese National Knowledge Infrastructure (CNKI) databases were searched from 1 January 2020 to 20 March 2022 for relevant literature. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to assess quality bias, STATA was employed to pool the effect size by a random effects model, and potential publication bias and sensitivity analyses were performed. Results 14 studies comprising 1822 patients with COVID-19 met the inclusion criteria, there were 1145 (62.8%) males and 677 (31.2%) females, and the mean age was 63.8 ± 16.1 years. The concentration of MR-proADM was compared between the survivors and non-survivors in 9 studies and the difference was significant (P < 0.01), I2 = 46%. The combined sensitivity was 0.86 [0.73–0.92], and the combined specificity was 0.78 [0.68–0.86]. We drew the summary receiver operating characteristic (SROC) curve and calculated the area under curve (AUC) = 0.90 [0.87–0.92]. An increase of 1 nmol/L of MR-proADM was independently associated with a more than threefold increase in mortality (odds ratio (OR) 3.03, 95% confidence interval (CI) 2.26–4.06, I2 = 0.0%, P = 0.633). The predictive value of MR-proADM for mortality was better than many other biomarkers. Conclusion MR-proADM had a very good predictive value for the poor prognosis of COVID-19 patients. Increased levels of MR-proADM were independently associated with mortality in COVID-19 patients and may allow a better risk stratification.

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Association between Fibrinogen-to-Albumin Ratio and Prognosis of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

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Although the fibrinogen-to-albumin ratio (F/R ratio) has been used as an inflammation marker to predict clinical outcomes in patients with cardiovascular diseases, its association with the prognosis of patients with coronavirus disease 2019 (COVID-19) remains unclear. Electronic databases including EMBASE, MEDLINE, Google Scholar, and Cochrane Library were searched from inception to 20 June 2022. The associations of F/R ratio with poor prognosis (defined as the occurrence of mortality or severe disease) were investigated in patients with COVID-19. A total of 10 studies (seven from Turkey, two from China, one from Croatia) involving 3675 patients published between 2020 and 2022 were eligible for quantitative syntheses. Merged results revealed a higher F/R ratio in the poor prognosis group (standardized mean difference: 0.529, p < 0.001, I2 = 84.8%, eight studies) than that in the good prognosis group. In addition, a high F/R ratio was associated with an increased risk of poor prognosis (odds ratio: 2.684, I2 = 59.5%, five studies). Pooled analysis showed a sensitivity of 0.75, specificity of 0.66, and area under curve of 0.77 for poor prognosis prediction. In conclusion, this meta-analysis revealed a positive correlation between F/A ratio and poor prognostic outcomes of COVID-19. Because of the limited number of studies included, further investigations are warranted to support our findings.

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The impact of daily troponin I and D-dimer serum levels on mortality in COVID-19 pneumonia patients

Cited by 3 publications

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The differences in troponin values among gender in COVID-19 patients

The differences in troponin values among gender in COVID-19 patients

Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

Association between Fibrinogen-to-Albumin Ratio and Prognosis of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

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