Related Experiment Video
Updated: Nov 13, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Coronavirus disease 2019: a comprehensive review and meta-analysis on cardiovascular biomarkers
Zhiyi Qiang1, Bing Wang2, Brenda C Garrett1
1Select Laboratory Partners, Greensboro, North Carolina.
Insights
COVID-19 infection can lead to long-term cardiovascular risks, including heart failure. Cardiac biomarkers like troponin T can identify patients at highest risk for adverse outcomes, guiding preventive cardiology strategies.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarkers
Background:
- The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic disproportionately affects individuals with pre-existing medical conditions.
- Cardiovascular disorders represent a significant risk factor for severe COVID-19 outcomes and mortality.
- Emerging evidence suggests COVID-19 infection may lead to persistent cardiovascular damage.
Purpose of the Study:
- To systematically review and meta-analyze the association between COVID-19 severity and cardiac-specific biomarkers.
- To identify which biomarkers are most strongly correlated with adverse COVID-19 outcomes.
- To highlight the role of preventive cardiology in managing COVID-19 patients.
Main Methods:
- Systematic review and meta-analysis of studies investigating COVID-19 severity and cardiac biomarkers.
- Focus on biomarkers including N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin T (TnT)/troponin I (TnI), lactate dehydrogenase (LDH), creatine kinase, and creatine kinase isoenzyme (CK-MB).
- Statistical analysis to determine the odds ratio (OR) for each biomarker's association with COVID-19 severity.
Main Results:
- All studied cardiac biomarkers were significantly correlated with COVID-19 severity, including ICU admission and mortality (P < 0.0001, except P < 0.01 for CK-MB).
- Troponin T (TnT) demonstrated the highest odds ratio (11.83), indicating the strongest association with COVID-19 severity.
- Other significant biomarkers included NT-proBNP (OR 7.57), TnI (OR 6.32), LDH (OR 4.79), D-dimer (OR 4.10), creatine kinase (OR 3.43), and CK-MB (OR 3.35).
Conclusions:
- COVID-19 infection poses both short-term and long-term risks for cardiovascular health, potentially leading to conditions like heart failure.
- Cardiac-specific biomarkers are valuable in identifying COVID-19 patients at high risk of adverse medical outcomes.
- Preventive cardiology is crucial during the pandemic, and further research on the use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACE-I) is warranted.
Purpose Of Review:
Preventive cardiology has an important role to play in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The SARS-CoV-2 pandemic has been observed to have a greater mortality impact on subgroups of people in the population who are deemed to be at higher medical disease risk. Individuals with cardiovascular disorders are one such COVID-19-associated high-mortality risk group.
Recent Findings:
Evidence is accumulating that COVID-19 infection may worsen an individual's future cardiovascular health, and, preinfection/postinfection cardiovascular evaluation may be warranted to determine if progressive cardiovascular damage has occurred because of COVID-19 infection. In this study, we conducted a systematic review and meta-analysis, focusing on the association between COVID-19 severity and cardiac-specific biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin T (TnT)/troponin I (TnI), lactate dehydrogenase (LDH), creatine kinase, and creatine kinase isoenzyme (CK-MB). TnT had the highest odds ratio or OR (11.83) indicating the greatest association with COVID-19 severity, followed by NT-proBNP (7.57), TnI (6.32), LDH (4.79), D-dimer (4.10), creatine kinase (3.43), and CK-MB (3.35). All of the biomarkers studied were significantly correlated with COVID-19 severity including severe symptoms, ICU care, and mortality (P < 0.0001, except P < 0.01 for CK-MB).
Summary:
COVID-19 infection results in short-term and long-term disease risk that may involve adverse cardiovascular health issues including heart failure. Cardiac-specific biomarkers appear to identify a subset of COVID-19 patients who have the highest risk of an adverse medical outcome. Preventive cardiology has an important role to play in the COVID-19 pandemic.The risk/benefit analysis of maintaining or eliminating the use of the angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitor (ACE-I) medications deserves further investigation.
More Related Videos
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Coronary Artery Disease IV: Preventive Measures
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Coronary Artery Disease I: Introduction