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Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19.
Qin, Juan-Juan; Cheng, Xu; Zhou, Feng; Lei, Fang; Akolkar, Gauri; Cai, Jingjing; Zhang, Xiao-Jing; Blet, Alice; Xie, Jing; Zhang, Peng; Liu, Ye-Mao; Huang, Zizhen; Zhao, Ling-Ping; Lin, Lijin; Xia, Meng; Chen, Ming-Ming; Song, Xiaohui; Bai, Liangjie; Chen, Ze; Zhang, Xingyuan; Xiang, Da; Chen, Jing; Xu, Qingbo; Ma, Xinliang; Touyz, Rhian M; Gao, Chen; Wang, Haitao; Liu, Liming; Mao, Weiming; Luo, Pengcheng; Yan, Youqin; Ye, Ping; Chen, Manhua; Chen, Guohua; Zhu, Lihua; She, Zhi-Gang; Huang, Xiaodong; Yuan, Yufeng; Zhang, Bing-Hong; Wang, Yibin; Liu, Peter P; Li, Hongliang.
  • Qin JJ; From the Department of Cardiology (J.-J.Q.), Zhongnan Hospital of Wuhan University, China.
  • Cheng X; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Zhou F; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Lei F; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Akolkar G; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Cai J; Medical Science Research Center (F.Z., P.Z., H.L.), Zhongnan Hospital of Wuhan University, China.
  • Zhang XJ; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Blet A; Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).
  • Xie J; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Zhang P; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.).
  • Huang Z; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Zhao LP; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Lin L; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.).
  • Xia M; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Chen MM; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.).
  • Song X; Medical Science Research Center (F.Z., P.Z., H.L.), Zhongnan Hospital of Wuhan University, China.
  • Bai L; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Chen Z; Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (G.A., A.B., P.P.L.).
  • Zhang X; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Xiang D; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Chen J; Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).
  • Xu Q; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Ma X; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Touyz RM; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Gao C; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Wang H; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Liu L; Department of Cardiology (J.-J.Q., X.C., X.-J.Z., J.X., Y.-M.L., L.L., M.-M.C., L.Z., Z.-G.S., H.L.), Renmin Hospital of Wuhan University, China.
  • Mao W; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Luo P; Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).
  • Yan Y; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Ye P; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Chen M; Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).
  • Chen G; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Zhu L; Basic Medical School, Wuhan University, China (F.L., Z.H., X.S., Z.C., X.Z., H.L.).
  • She ZG; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Huang X; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Yuan Y; Institute of Model Animal of Wuhan University, China (J.-J.Q., X.C., F.Z., F.L., X.-J.Z., P.Z., Y.-M.L., Z.H., L.-P.Z., L.L., M.X., M.-M.C., X.S., L.B., Z.C., X.Z., D.X., J. Chen, L.Z., Z.-G.S., H.L.).
  • Zhang BH; Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.).
  • Wang Y; Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania (X.M.).
  • Liu PP; Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (R.M.T.).
  • Li H; Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (C.G., Y.W.).
Hypertension ; 76(4): 1104-1112, 2020 10.
Article in English | MEDLINE | ID: covidwho-992137
ABSTRACT
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 multicentered retrospective study, we enrolled 3219 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-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60-11.03] P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50-7.47] P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33-7.09] P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18-6.36] P<0.001), and CK was 3.56 ([95% CI, 2.53-5.02] P<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 19%-50% 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 cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Peptide Fragments / Pneumonia, Viral / Coronavirus Infections / Troponin I / Natriuretic Peptide, Brain / Creatine Kinase, MB Form / Pandemics / Heart Diseases Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Hypertension Year: 2020 Document Type: Article Affiliation country: HYPERTENSIONAHA.120.15528

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Peptide Fragments / Pneumonia, Viral / Coronavirus Infections / Troponin I / Natriuretic Peptide, Brain / Creatine Kinase, MB Form / Pandemics / Heart Diseases Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Hypertension Year: 2020 Document Type: Article Affiliation country: HYPERTENSIONAHA.120.15528