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Risk stratification and prognosis prediction using cardiac biomarkers in COVID-19: a single-centre retrospective
Madoka Sano1, Toshiaki Toyota2, Takeshi Morimoto3
1Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
Insights
Elevated cardiac biomarkers like hsTnI and NT-proBNP indicate a higher risk of death in COVID-19 patients. These markers can help stratify patient risk and guide clinical decisions for better outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarkers
Background:
- COVID-19 poses a significant risk, necessitating tools for patient risk stratification.
- Cardiac biomarkers are increasingly recognized for their prognostic potential in various critical illnesses.
Purpose of the Study:
- To evaluate the prognostic value of cardiac biomarkers in stratifying risk among hospitalized COVID-19 patients.
- To assess the association between specific cardiac biomarkers and all-cause mortality in COVID-19.
Main Methods:
- A retrospective cohort study included 917 COVID-19 patients.
- Cardiac biomarkers including high-sensitive troponin I (hsTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK), and CK myocardial band (CK-MB) were measured.
- Patients were stratified based on clinically relevant thresholds, and the primary outcome was 30-day all-cause death.
Main Results:
- Elevated levels of hsTnI, NT-proBNP, CK, and CK-MB were significantly associated with increased 30-day cumulative incidence of all-cause death.
- Specific thresholds for each biomarker demonstrated a dose-dependent relationship with mortality risk.
- Adjusted analysis confirmed the significant association between cardiac biomarker elevation and increased risk of death.
Conclusions:
- Elevation of cardiac biomarkers is a significant indicator of poor prognosis in COVID-19 patients.
- Cardiac biomarkers can serve as valuable tools for risk stratification in COVID-19 management.
- Further research may explore the integration of these biomarkers into clinical decision-making algorithms.
Objective:
There is a need for a robust tool to stratify the patient's risk with COVID-19. We assessed the prognostic values of cardiac biomarkers for COVID-19 patients.
Methods:
This is a single-centre retrospective cohort study. Consecutive laboratory-confirmed COVID-19 patients admitted to the Kobe City Medical Center General Hospital from July 2020 to September 2021 were included. We obtained cardiac biomarker values from electronic health records and institutional blood banks. We stratified patients with cardiac biomarkers as high-sensitive troponin I (hsTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK) and CK myocardial band (CK-MB), using the clinically relevant thresholds. Prespecified primary outcome measure was all-cause death.
Results:
A total of 917 patients were included. hsTnI, NT-proBNP, CK and CK-MB were associated with the significantly higher cumulative 30-day incidence of all-cause death (hsTnI: <5.0 ng/L group; 4.3%, 5.0 ng/L-99%ile upper reference limit (URL) group; 8.8% and ≥99% ile URL group; 25.2%, p<0.001. NT-proBNP: <125 pg/mL group; 5.3%, 125-900 pg/mL group; 10.5% and ≥900 pg/mL group; 31.9%, p<0.001. CK:
Conclusions:
Elevation of cardiac biomarkers was associated with poor prognosis of COVID-19 patients.
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