Biomarkers and short-term prognosis in COVID-19

Area of Science:

• Biomarkers in infectious diseases
• Prognostic markers in critical care
• COVID-19 research

Background:

• COVID-19 poses significant short-term mortality risks.
• Identifying reliable prognostic biomarkers is crucial for patient management.
• Biomarkers like cTnI, D-dimer, CRP, and LDH are potential indicators of disease severity.

Purpose of the Study:

• To analyze the short-term prognostic value of cardiac troponin I (cTnI), D-dimer, C-reactive protein (CRP), and lactate dehydrogenase (LDH) in COVID-19 patients.
• To compare the predictive accuracy of these biomarkers for 30-day all-cause mortality.

Main Methods:

• Retrospective analysis of patients admitted with COVID-19.
• Measurement of serum concentrations of cTnI, D-dimer, CRP, and LDH.
• Classification of patients based on biomarker levels (low vs. high) using optimal cut-off points.
• Evaluation of 30-day all-cause mortality using multivariate analysis.

Main Results:

• Elevated levels of cTnI (≥21 ng/L), D-dimer (≥1112 ng/mL), CRP (≥10 mg/dL), and LDH (≥334 U/L) were significantly associated with increased 30-day mortality risk.
• Cardiac troponin I demonstrated the highest predictive accuracy (AUC 0.825), outperforming CRP and LDH.
• The predictive performance of cTnI was non-significantly better than D-dimer (AUC 0.756).

Conclusions:

• Increased concentrations of cTnI, D-dimer, CRP, and LDH are associated with short-term mortality in COVID-19 patients.
• Cardiac troponin I serves as a superior predictor of mortality risk compared to CRP and LDH.
• While D-dimer also shows prognostic value, its difference in predictive accuracy compared to cTnI was not statistically significant.