Myocardium injury biomarkers predict prognosis of critically ill coronavirus disease 2019 (COVID-19) patients

Ann Palliat Med. 2020 Nov;9(6):4156-4165. doi: 10.21037/apm-20-2112.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic is a once-in-century crisis to public health. Although the pathogen for COVID-19, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been identified, the pandemic is still ongoing. The critically ill COVID-19 patients account for most disease-associated death; thus, there is an urgent need to identify prognostic factors that would help determine therapeutic approaches.

Methods: In this study, we retrospectively analyzed the clinical and laboratory findings in 100 critically ill COVID-19 patients in Hubei Women & Children Healthcare Hospital (Guanggu District), of whom 22 patients died in hospital, and 78 patients survived.

Results: We found that age, lymphocyte count, and total bilirubin concentration were an independent prognostic factor for critically ill COVID-19 patients. Of particular importance, we observed a significant elevation of myocardium injury biomarkers, including CK-MB, high-sensitivity cardiac troponini I (hs-cTnI), and Mb, in the non-survivor group. These myocardium injury biomarkers appeared to correlate with the time of survival, and two multivariate models have suggested hs-cTnI was a novel prognostic factor with a sensitivity of 75.0% and a specificity of 84.9%.

Conclusions: Altogether, our study highlighted the prognostic significance of myocardium injury biomarkers in critically ill COVID-19 patients. Monitoring myocardium injury biomarkers would predict patient survival and guide therapeutic strategy.

Keywords: Coronavirus disease 2019 (COVID-19); high-sensitivity cardiac troponini I (hs-cTnI); myocardium injury biomarkers; prognostic factor; severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • COVID-19 / epidemiology
  • COVID-19 / metabolism
  • COVID-19 / pathology*
  • COVID-19 / virology
  • Cardiomyopathies / complications
  • Cardiomyopathies / metabolism*
  • China / epidemiology
  • Critical Illness*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Prognosis
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification

Substances

  • Biomarkers