TY - JOUR
AU - Qin, Juan-Juan
AU - Cheng, Xu
AU - Zhou, Feng
AU - Lei, Fang
AU - Akolkar, Gauri
AU - Cai, Jingjing
AU - Zhang, Xiao-Jing
AU - Blet, Alice
AU - Xie, Jing
AU - Zhang, Peng
AU - Liu, Ye-Mao
AU - Huang, Zizhen
AU - Zhao, Ling-Ping
AU - Lin, Lijin
AU - Xia, Meng
AU - Chen, Ming-Ming
AU - Song, Xiaohui
AU - Bai, Liangjie
AU - Chen, Ze
AU - Zhang, Xingyuan
AU - Xiang, Da
AU - Chen, Jing
AU - Xu, Qingbo
AU - Ma, Xinliang
AU - Touyz, Rhian M.
AU - Gao, Chen
AU - Wang, Haitao
AU - Liu, Liming
AU - Mao, Weiming
AU - Luo, Pengcheng
AU - Yan, Youqin
AU - Ye, Ping
AU - Chen, Manhua
AU - Chen, Guohua
AU - Zhu, Lihua
AU - She, Zhi-Gang
AU - Huang, Xiaodong
AU - Yuan, Yufeng
AU - Zhang, Bing-Hong
AU - Wang, Yibin
AU - Liu, Peter P.
AU - Li, Hongliang
PY - 2020
DA - October
TI - Redefining cardiac biomarkers in predicting mortality and adverse outcomes of inpatients with COVID-19
JO - Hypertension
EP - 1112
VL - 76
IS - 4
DO - http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.15528
AB - The prognostic power of circulating cardiac biomarkers, their utility and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multi-centered retrospective study, we enrolled 3,219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effect Cox model, after adjusting for age, gender and comorbidities, the adjusted hazard ratios of 28-day mortality for high-sensitivity cardiac troponin I (hs-cTnI) was 7.12 (95%CI, 4.60-11.03; P&lt;0.001), NT-proB-type natriuretic peptide (NT-proBNP) was 5.11 (95%CI, 3.50-7.47; P&lt;0.001), CK-MB was 4.86 (95%CI, 3.33-7.09; P&lt;0.001), myoglobin was 4.50 (95%CI, 3.18-6.36; P &lt; 0.001), and CK was 3.56 (95%CI, 2.53-5.02; P &lt; 0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 49% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoffs for of these values might be much lower than the current reference standards. These findings can assist better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19 associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.
PB - American Heart Association
UR - http://eprints.gla.ac.uk/220080/
KW - Coronavirus (COVID-19)
ER