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Impact of congestive heart failure and role of cardiac biomarkers in COVID-19 patients: A systematic review and meta-analysis.
Dalia, Tarun; Lahan, Shubham; Ranka, Sagar; Acharya, Prakash; Gautam, Archana; Goyal, Amandeep; Mastoris, Ioannis; Sauer, Andrew; Shah, Zubair.
  • Dalia T; Department of Cardiovascular Medicine, The University of Kansas Health System, KS, USA.
  • Lahan S; University College of Medical Sciences, New Delhi, India.
  • Ranka S; Department of Cardiovascular Medicine, The University of Kansas Health System, KS, USA.
  • Acharya P; Department of Cardiovascular Medicine, The University of Kansas Health System, KS, USA.
  • Gautam A; Department of Nephrology, The University of Kansas Health System, KS, USA.
  • Goyal A; Research and Clinical Fellow, Advanced heart failure and transplant division, University of Kansas Medical Center, Kansas City, Kansas, USA. Electronic address: agoyal3@kumc.edu.
  • Mastoris I; Department of Cardiovascular Medicine, The University of Kansas Health System, KS, USA.
  • Sauer A; Department of Cardiovascular Medicine, The University of Kansas Health System, KS, USA.
  • Shah Z; Department of Cardiovascular Medicine, The University of Kansas Health System, KS, USA. Electronic address: zshah2@kumc.edu.
Indian Heart J ; 73(1): 91-98, 2021.
Article in English | MEDLINE | ID: covidwho-957113
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Congestive heart failure PROCESS_OF Patients
Subject
Congestive heart failure
Predicate
PROCESS_OF
Object
Patients
3. Heart Injuries PROCESS_OF Patients
Subject
Heart Injuries
Predicate
PROCESS_OF
Object
Patients
4. Cardiovascular Diseases PROCESS_OF Patients
Subject
Cardiovascular Diseases
Predicate
PROCESS_OF
Object
Patients
5. Cardiovascular LOCATION_OF Comorbidity
Subject
Cardiovascular
Predicate
LOCATION_OF
Object
Comorbidity
6. Increased risk PROCESS_OF Survivors
Subject
Increased risk
Predicate
PROCESS_OF
Object
Survivors
7. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
8. Creatine Kinase MB Isoenzyme PART_OF Patients
Subject
Creatine Kinase MB Isoenzyme
Predicate
PART_OF
Object
Patients
9. Troponin I PART_OF Patients
Subject
Troponin I
Predicate
PART_OF
Object
Patients
10. pro-brain natriuretic peptide (1-76) PART_OF Patients
Subject
pro-brain natriuretic peptide (1-76)
Predicate
PART_OF
Object
Patients
11. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
13. Congestive heart failure PROCESS_OF Patients
Subject
Congestive heart failure
Predicate
PROCESS_OF
Object
Patients
14. Heart Injuries PROCESS_OF Patients
Subject
Heart Injuries
Predicate
PROCESS_OF
Object
Patients
15. Cardiovascular Diseases PROCESS_OF Patients
Subject
Cardiovascular Diseases
Predicate
PROCESS_OF
Object
Patients
16. Cardiovascular LOCATION_OF Comorbidity
Subject
Cardiovascular
Predicate
LOCATION_OF
Object
Comorbidity
17. Increased risk PROCESS_OF Survivors
Subject
Increased risk
Predicate
PROCESS_OF
Object
Survivors
18. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
19. Creatine Kinase MB Isoenzyme PART_OF Patients
Subject
Creatine Kinase MB Isoenzyme
Predicate
PART_OF
Object
Patients
20. Troponin I PART_OF Patients
Subject
Troponin I
Predicate
PART_OF
Object
Patients
21. pro-brain natriuretic peptide (1-76) PART_OF Patients
Subject
pro-brain natriuretic peptide (1-76)
Predicate
PART_OF
Object
Patients
22. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) has been reported to cause worse outcomes in patients with underlying cardiovascular disease, especially in patients with acute cardiac injury, which is determined by elevated levels of high-sensitivity troponin. There is a paucity of data on the impact of congestive heart failure (CHF) on outcomes in COVID-19 patients.

METHODS:

We conducted a literature search of PubMed/Medline, EMBASE, and Google Scholar databases from 11/1/2019 till 06/07/2020, and identified all relevant studies reporting cardiovascular comorbidities, cardiac biomarkers, disease severity, and survival. Pooled data from the selected studies was used for metanalysis to identify the impact of risk factors and cardiac biomarker elevation on disease severity and/or mortality.

RESULTS:

We collected pooled data on 5967 COVID-19 patients from 20 individual studies. We found that both non-survivors and those with severe disease had an increased risk of acute cardiac injury and cardiac arrhythmias, our pooled relative risk (RR) was - 8.52 (95% CI 3.63-19.98) (p < 0.001); and 3.61 (95% CI 2.03-6.43) (p = 0.001), respectively. Mean difference in the levels of Troponin-I, CK-MB, and NT-proBNP was higher in deceased and severely infected patients. The RR of in-hospital mortality was 2.35 (95% CI 1.18-4.70) (p = 0.022) and 1.52 (95% CI 1.12-2.05) (p = 0.008) among patients who had pre-existing CHF and hypertension, respectively.

CONCLUSION:

Cardiac involvement in COVID-19 infection appears to significantly adversely impact patient prognosis and survival. Pre-existence of CHF, and high cardiac biomarkers like NT-pro BNP and CK-MB levels in COVID-19 patients correlates with worse outcomes.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Biomarkers / COVID-19 / Heart Failure Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Indian Heart J Year: 2021 Document Type: Article Affiliation country: J.ihj.2020.12.002

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Biomarkers / COVID-19 / Heart Failure Type of study: Experimental Studies / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Indian Heart J Year: 2021 Document Type: Article Affiliation country: J.ihj.2020.12.002