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Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19.

Publication ,  Journal Article
Qin, J-J; Cheng, X; Zhou, F; Lei, F; Akolkar, G; Cai, J; Zhang, X-J; Blet, A; Xie, J; Zhang, P; Liu, Y-M; Huang, Z; Zhao, L-P; Lin, L ...
Published in: Hypertension
October 2020

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.

Duke Scholars

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Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

October 2020

Volume

76

Issue

4

Start / End Page

1104 / 1112

Location

United States

Related Subject Headings

  • Troponin I
  • SARS-CoV-2
  • Retrospective Studies
  • Prognosis
  • Predictive Value of Tests
  • Pneumonia, Viral
  • Peptide Fragments
  • Pandemics
  • Outcome Assessment, Health Care
  • Natriuretic Peptide, Brain
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Qin, J.-J., Cheng, X., Zhou, F., Lei, F., Akolkar, G., Cai, J., … Li, H. (2020). Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19. Hypertension, 76(4), 1104–1112. https://doi.org/10.1161/HYPERTENSIONAHA.120.15528
Qin, Juan-Juan, Xu Cheng, Feng Zhou, Fang Lei, Gauri Akolkar, Jingjing Cai, Xiao-Jing Zhang, et al. “Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19.Hypertension 76, no. 4 (October 2020): 1104–12. https://doi.org/10.1161/HYPERTENSIONAHA.120.15528.
Qin J-J, Cheng X, Zhou F, Lei F, Akolkar G, Cai J, et al. Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19. Hypertension. 2020 Oct;76(4):1104–12.
Qin, Juan-Juan, et al. “Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19.Hypertension, vol. 76, no. 4, Oct. 2020, pp. 1104–12. Pubmed, doi:10.1161/HYPERTENSIONAHA.120.15528.
Qin J-J, Cheng X, Zhou F, Lei F, Akolkar G, Cai J, Zhang X-J, Blet A, Xie J, Zhang P, Liu Y-M, Huang Z, Zhao L-P, Lin L, Xia M, Chen M-M, Song X, Bai L, Chen Z, Zhang X, Xiang D, Chen J, Xu Q, Ma X, Touyz RM, Gao C, Wang H, Liu L, Mao W, Luo P, Yan Y, Ye P, Chen M, Chen G, Zhu L, She Z-G, Huang X, Yuan Y, Zhang B-H, Wang Y, Liu PP, Li H. Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19. Hypertension. 2020 Oct;76(4):1104–1112.

Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

October 2020

Volume

76

Issue

4

Start / End Page

1104 / 1112

Location

United States

Related Subject Headings

  • Troponin I
  • SARS-CoV-2
  • Retrospective Studies
  • Prognosis
  • Predictive Value of Tests
  • Pneumonia, Viral
  • Peptide Fragments
  • Pandemics
  • Outcome Assessment, Health Care
  • Natriuretic Peptide, Brain