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The prognostic value of elevated creatine kinase to predict poor outcome in patients with COVID-19 - A systematic review and meta-analysis.
Akbar, Mohammad Rizki; Pranata, Raymond; Wibowo, Arief; Lim, Michael Anthonius; Sihite, Teddy Arnold; Martha, Januar Wibawa.
  • Akbar MR; Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia. Electronic address: m.r.akbar@unpad.ac.id.
  • Pranata R; Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia; Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Electronic address: raymond_pranata@hotmail.com.
  • Wibowo A; Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia. Electronic address: ariefwibowo.doc@gmail.com.
  • Lim MA; Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Electronic address: lim.michael.a@gmail.com.
  • Sihite TA; Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia. Electronic address: teddysyhyte@yahoo.com.
  • Martha JW; Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia. Electronic address: jwmartha@gmail.com.
Diabetes Metab Syndr ; 15(2): 529-534, 2021.
Article in English | MEDLINE | ID: covidwho-1131232
ABSTRACT
BACKGROUND AND

AIMS:

Creatine kinase (CK), a marker of muscle damage, is potentially associated with a more severe COVID-19. In this systematic review and meta-analysis, we aim to evaluate the association between the elevated CK and severity and mortality in COVID-19.

METHODS:

We performed a systematic literature search on PubMed, Scopus, and Embase up until January 26, 2020. The main outcome was poor outcome, a composite of mortality and severe COVID-19.

RESULTS:

There are 2471 patients from 14 studies included in this systematic review and meta-analysis. The incidence of elevated CK in this pooled analysis was 17% (11%, 22%) and the incidence of poor outcome in this pooled analysis was 27% (19%, 34%). Elevated CK was associated with poor outcome in patients with COVID-19 (OR 3.01 [2.21, 4.10], p < 0.001; I2 10.2%). The effect estimate did not vary with age (p = 0.610), male (p = 0.449), hypertension (p = 0.490), and diabetes (p = 0.457). Elevated CK has a sensitivity of 0.24 (0.17, 0.32), specificity of 0.91 (0.86, 0.94), PLR of 2.6 (1.9, 3.7), NLR of 0.84 (0.78, 0.90), DOR of 3 (2, 5), and AUC of 0.62 (0.57, 0.66) for predicting poor outcome in patients with COVID-19. In this pooled analysis, elevated CK confers to a 49% probability for poor outcome and a non-elevated CK confers to a 24% probability. Subgroup analysis and univariate meta-regression indicates that the sensitivity and specificity does not vary with age, male, hypertension, and diabetes.

CONCLUSION:

Elevated CK was associated with increased mortality and severity in patients with COVID-19. PROSPERO CRD42021233435.
Subject(s)
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Creatine Kinase / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Diabetes Metab Syndr Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Creatine Kinase / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Diabetes Metab Syndr Year: 2021 Document Type: Article