Related Experiment Video
Updated: Oct 10, 2025
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Heart Failure Probability and Early Outcomes of Critically Ill Patients With COVID-19: A Prospective, Multicenter
Weibo Gao1, Jiasai Fan2, Di Sun2
1Department of Emergency, Peking University People's Hospital, Beijing, China.
Insights
Heart failure (HF) significantly increases 30-day mortality in critically ill COVID-19 patients. A novel nomogram using NT-proBNP levels aids in predicting mortality risk for better patient management.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
- Biomarkers
Background:
- The prognostic significance of cardiac dysfunction in coronavirus disease 2019 (COVID-19) remains underappreciated.
- Investigating the role of heart failure (HF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in critically ill COVID-19 patients is crucial for improving outcomes.
- Developing predictive models for COVID-19 mortality is essential for timely clinical intervention.
Purpose of the Study:
- To explore the association between heart failure (HF) and NT-proBNP levels with the prognosis of critically ill COVID-19 patients.
- To develop and validate a machine learning-based predictive model for 30-day all-cause mortality in this patient cohort.
Main Methods:
- A prospective, multicenter study enrolled 402 laboratory-confirmed critically ill COVID-19 patients.
- A 'triple cut-point' strategy for NT-proBNP was used to assess HF probability.
- Machine learning techniques, including LASSO and logistic regression, were employed to identify prognostic factors and construct a predictive nomogram.
Main Results:
- The 30-day all-cause mortality rate was 27.4%.
- Patients with likely HF had significantly higher mortality (40.8%) compared to those with gray zone (25%) or unlikely HF (16.5%) (P < 0.001).
- Independent predictors of mortality included likely HF, age, lymphocyte count, albumin, and total bilirubin. The nomogram achieved a C-index of 0.8.
Conclusions:
- A novel nomogram effectively predicts 30-day mortality in critically ill COVID-19 patients.
- The 'triple cut-point' NT-proBNP strategy plays a significant role in risk stratification.
- This tool can aid clinicians in identifying high-risk patients and potentially improve clinical outcomes.
Abstract:
Background: The relationship between cardiac functions and the fatal outcome of coronavirus disease 2019 (COVID-19) is still largely underestimated. We aim to explore the role of heart failure (HF) and NT-proBNP in the prognosis of critically ill patients with COVID-19 and construct an easy-to-use predictive model using machine learning. Methods: In this multicenter and prospective study, a total of 1,050 patients with clinical suspicion of COVID-19 were consecutively screened. Finally, 402 laboratory-confirmed critically ill patients with COVID-19 were enrolled. A "triple cut-point" strategy of NT-proBNP was applied to assess the probability of HF. The primary outcome was 30-day all-cause in-hospital death. Prognostic risk factors were analyzed using the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression, further formulating a nomogram to predict mortality. Results: Within a 30-day follow-up, 27.4% of the 402 patients died. The mortality rate of patients with HF likely was significantly higher than that of the patient with gray zone and HF unlikely (40.8% vs. 25 and 16.5%, respectively, P < 0.001). HF likely [Odds ratio (OR) 1.97, 95% CI 1.13-3.42], age (OR 1.04, 95% CI 1.02-1.06), lymphocyte (OR 0.36, 95% CI 0.19-0.68), albumin (OR 0.92, 95% CI 0.87-0.96), and total bilirubin (OR 1.02, 95% CI 1-1.04) were independently associated with the prognosis of critically ill patients with COVID-19. Moreover, a nomogram was developed by bootstrap validation, and C-index was 0.8 (95% CI 0.74-0.86). Conclusions: This study established a novel nomogram to predict the 30-day all-cause mortality of critically ill patients with COVID-19, highlighting the predominant role of the "triple cut-point" strategy of NT-proBNP, which could assist in risk stratification and improve clinical sequelae.
More Related Videos
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:26Heart Failure III: Clinical Manifestations
01:30Heart Failure VII: Nursing Interventions
01:29Heart Failure II: Pathophysiology
01:27Heart Failure I: Introduction