IS IT MEANINGFUL FOR SERUM MYOGLOBIN IN PATIENTS WITH COVID-19 DECREASED?

Area of Science:

• Cardiology
• Infectious Diseases
• Biochemistry

Background:

• The COVID-19 pandemic continues to be a global health emergency.
• In January 2023, China reclassified COVID-19 management to Category B, with a significant decrease in hospital cases post-peak.
• Serum myoglobin is a cardiac biomarker, typically increasing with myocardial damage.

Approach:

• Retrospective analysis of 1142 COVID-19 patients presenting with chest symptoms to an emergency department in January 2023.
• Focused on 956 patients with serum myoglobin levels below the reference interval, presenting more than two weeks after initial symptom onset.
• Evaluated electrocardiograms, chest CT scans, cardiac enzymes, and blood cell counts; excluded myocardial damage and acute pulmonary infection.

Key Points:

• A significant decrease in serum myoglobin was observed in 956 COVID-19 patients, a finding not previously reported.
• These patients, experiencing symptoms like palpitations, showed no evidence of myocardial damage or acute pulmonary infection.
• The low myoglobin levels, coupled with the absence of cardiac enzyme elevation, suggest potential SARS-CoV-2 related cardiac nerve dysfunction rather than direct myocardial injury.

Conclusions:

• Low serum myoglobin in COVID-19 patients may indicate nerve damage rather than heart muscle damage.
• This observation suggests that cardiac nerves could be a potential therapeutic target for treating COVID-19 symptoms.
• Further research is needed to validate these findings and explore therapeutic strategies targeting cardiac nerves.