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Possible role of higher serum level of myoglobin as predictor of worse prognosis in Sars-Cov 2 hospitalized patients. A monocentric retrospective study.
Rotondo, Cinzia; Corrado, Addolorata; Colia, Ripalta; Maruotti, Nicola; Sciacca, Stefania; Lops, Lucia; Cici, Daniela; Mele, Angiola; Trotta, Antonello; Lacedonia, Donato; Foschino Barbaro, Maria Pia; Cantatore, Francesco Paolo.
  • Rotondo C; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Corrado A; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Colia R; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Maruotti N; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Sciacca S; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Lops L; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Cici D; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Mele A; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Trotta A; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
  • Lacedonia D; Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
  • Foschino Barbaro MP; Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
  • Cantatore FP; Department of Medical and Surgical Sciences - Rheumatology Unit, University of Foggia, Foggia, Italy.
Postgrad Med ; 133(6): 688-693, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1284777
ABSTRACT

BACKGROUND:

Limited data on myoglobin and infectious diseases are available. In this study, we evaluate the potential role of myoglobin in predicting poor outcome in patients with Sars-Cov2 pneumonia.

METHODS:

One hundred and twenty-one Sars-Cov 2 patients with an average age of 69.9 ± 13.2 years, and symptoms duration of 8.8 ± 7.9 days were enrolled in the study. At the admission, the serum levels of myoglobin, erythrocyte sedimentation rate, C reactive protein (CRP), procalcitonin, ferritin, creatine phosphokinase, creatinine, fibrinogen, d-dimers, lactic dehydrogenase, troponin (Tn-I), creatine kinase myocardial band (CK-MB), complement fractions C3 and C4, immunoglobulins, interleukin 6 were evaluated. We also assessed the patients' complete clinical history and performed a thorough physical examination including age, disease history, and medications.

RESULTS:

Twenty-four (20%) patients died, and 18 (15%) patients required intensive care. The mean time between symptoms onset and death was 12.4 days ± 9.1. Univariate analysis of the patients' data highlighted some independent risk factors for mortality in COVID-19, including higher neutrophils rate (HR 1.171), lower lymphocyte rate (HR 0.798), high CK-MB serum levels (HR 1.6), high Tn-I serum levels (HR 1.03), high myoglobin serum levels (HR 1.014), Alzheimer (HR 5.8), and higher CRP values (HR 1.011). Cox regression analysis model revealed that higher serum values of myoglobin (HR 1.003; 95%CI 1.001-1.006; p = 0.01), and CRP (HR 1.012; 95% CI 1.001-1.023; p = 0.035) could be predictors of mortality in COVID-19 patients. The value of the myoglobin level for predicting 28 days-mortality using ROC curve was 121.8 ng/dL. Lower survival rate was observed in patients with serum levels of myoglobin>121.8 ng/dL (84% vs 20% respectively, p = 0.0001).

CONCLUSION:

Our results suggest that higher serum levels of myoglobin could be a considerable and effective predictor of poor outcomes in COVID-19 patients; a careful follow-up in these patients is strongly suggested. The possibility of enhancing these findings in other cohorts of COVID-19 patients could validate the clinical value of myoglobin as a biomarker for worse prognosis in COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Risk Assessment / Critical Care / COVID-19 / Myoglobin Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Postgrad Med Year: 2021 Document Type: Article Affiliation country: 00325481.2021.1949211

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Risk Assessment / Critical Care / COVID-19 / Myoglobin Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Postgrad Med Year: 2021 Document Type: Article Affiliation country: 00325481.2021.1949211