Relation between Cardiac Injury and Elevated Levels of Inflammatory Biomarkers in Patients with Severe COVID-19

ABSTRACT

Background: Since early December 2019, coronavirus disease 2019 (COVID-19) has emerged as a global pandemic and public health crisis. This study aims to explore the relationship between cardiac injury and inflammatory biomarkers in patients with severe COVID-19. Methods: We collected data on 91 patients with a confirmed diagnosis of severe COVID-19 from February 8 to March 31, 2020. Demographic characteristics, clinical data, and in-hospital outcomes were compared. The relationship between cardiac injury and inflammatory biomarkers was analyzed. Logistic regression was used to explore the independent risk factors for cardiac injury. Results: The mean age of all patients was 61 years +/- 14 years. About half of the patients were male. Hypertension and coronary heart disease were more common in the cardiac injury group. The levels of inflammatory biomarkers in patients who experienced cardiac injury were generally higher than the levels of those without cardiac injury, including interleukin-6, interleukin-2 receptor (IL-2R), procalcitonin, and high-sensitivity C-reactive protein. There were positive correlations between the levels of high-sensitivity troponin I and N-terminal prohormone of brain natriuretic peptide and the levels of inflammatory biomarkers. Logistic regression shows that IL-2R (odds ratio 1.001, 95% confidence interval 1.000-1.002, P = 0.045) and comorbidities (odds ratio 4.909, 95% confidence interval 1.231-19.579, P = 0.024) are independent risk factors for cardiac injury in patients with severe COVID-19. Conclusion: High levels of inflammatory biomarkers are associated with higher risk of cardiac injury in patients with severe COVID-19. IL-2R and comorbidities are predictors of cardiac injury.