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Cardiac injury associated with severe disease or ICU admission and death in hospitalized patients with COVID-19: a meta-analysis and systematic review.
Li, Xinye; Pan, Xiandu; Li, Yanda; An, Na; Xing, Yanfen; Yang, Fan; Tian, Li; Sun, Jiahao; Gao, Yonghong; Shang, Hongcai; Xing, Yanwei.
  • Li X; Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
  • Pan X; Beijing University of Chinese Medicine, Beijing, China.
  • Li Y; Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
  • An N; Beijing University of Chinese Medicine, Beijing, China.
  • Xing Y; Institute of Basic Research In Clinical Medicine, China Academy Of Chinese Medical Sciences, Beijing, China.
  • Yang F; Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
  • Tian L; Shanxi University of Chinese Medicine, Taiyuan, China.
  • Sun J; Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
  • Gao Y; Beijing University of Chinese Medicine, Beijing, China.
  • Shang H; Beijing University of Chinese Medicine, Beijing, China.
  • Xing Y; Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
Crit Care ; 24(1): 468, 2020 07 28.
Artículo en Inglés | MEDLINE | ID: covidwho-679772
ABSTRACT

BACKGROUND:

Cardiac injury is now a common complication of coronavirus disease (COVID-19), but it remains unclear whether cardiac injury-related biomarkers can be independent predictors of mortality and severe disease development or intensive care unit (ICU) admission.

METHODS:

Two investigators searched the PubMed, EMBASE, Cochrane Library, MEDLINE, Chinese National Knowledge Infrastructure (CNKI), Wanfang, MedRxiv, and ChinaXiv databases for articles published through March 30, 2020. Retrospective studies assessing the relationship between the prognosis of COVID-19 patients and levels of troponin I (TnI) and other cardiac injury biomarkers (creatine kinase [CK], CK myocardial band [CK-MB], lactate dehydrogenase [LDH], and interleukin-6 [IL-6]) were included. The data were extracted independently by two investigators.

RESULTS:

The analysis included 23 studies with 4631 total individuals. The proportions of severe disease, ICU admission, or death among patients with non-elevated TnI (or troponin T [TnT]), and those with elevated TnI (or TnT) were 12.0% and 64.5%, 11.8% and 56.0%, and 8.2% and. 59.3%, respectively. Patients with elevated TnI levels had significantly higher risks of severe disease, ICU admission, and death (RR 5.57, 95% CI 3.04 to 10.22, P < 0.001; RR 6.20, 95% CI 2.52 to 15.29, P < 0.001; RR 5.64, 95% CI 2.69 to 11.83, P < 0.001). Patients with an elevated CK level were at significantly increased risk of severe disease or ICU admission (RR 1.98, 95% CI 1.50 to 2.61, P < 0.001). Patients with elevated CK-MB levels were at a higher risk of developing severe disease or requiring ICU admission (RR 3.24, 95% CI 1.66 to 6.34, P = 0.001). Patients with newly occurring arrhythmias were at higher risk of developing severe disease or requiring ICU admission (RR 13.09, 95% CI 7.00 to 24.47, P < 0.001). An elevated IL-6 level was associated with a higher risk of developing severe disease, requiring ICU admission, or death.

CONCLUSIONS:

COVID-19 patients with elevated TnI levels are at significantly higher risk of severe disease, ICU admission, and death. Elevated CK, CK-MB, LDH, and IL-6 levels and emerging arrhythmia are associated with the development of severe disease and need for ICU admission, and the mortality is significantly higher in patients with elevated LDH and IL-6 levels.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Lesiones Cardíacas / Unidades de Cuidados Intensivos Tipo de estudio: Estudio observacional / Estudio pronóstico / Revisiones / Revisión sistemática/Meta análisis Tópicos: Covid persistente Límite: Humanos Idioma: Inglés Revista: Crit Care Año: 2020 Tipo del documento: Artículo País de afiliación: S13054-020-03183-z

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Lesiones Cardíacas / Unidades de Cuidados Intensivos Tipo de estudio: Estudio observacional / Estudio pronóstico / Revisiones / Revisión sistemática/Meta análisis Tópicos: Covid persistente Límite: Humanos Idioma: Inglés Revista: Crit Care Año: 2020 Tipo del documento: Artículo País de afiliación: S13054-020-03183-z