Sorrentino Sabato, Cacia Michele, Leo Isabella, Polimeni Alberto, Sabatino Jolanda, Spaccarotella Carmen Anna Maria, Mongiardo Annalisa, De Rosa Salvatore, Indolfi Ciro
Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy.
Mediterranea Cardio Center, 80122 Naples, Italy.
J Clin Med. 2020 Sep 12;9(9):2957. doi: 10.3390/jcm9092957.
Up to 15% of coronavirus disease 2019 (COVID-19) patients experience severe clinical presentation, resulting in acute respiratory distress (ARDS) and finally death. N-terminal natriuretic peptide (NT-proBNP) is associated with a worse prognosis in patients with ARDS. However, whether or not this peptide can help discriminate high-risk COVID-19 patients remains unclear. Therefore, in this meta-analysis, we summarized the available evidence on NT-proBNP in patients admitted for COVID-19. Pooled mean, mean differences (MD) and standardized mean difference (SMD) were the summary metrics. Thirteen studies were finally selected for this analysis with a total of 2248 patients, of which 507 had a severe condition (n = 240) or died (n = 267). Pooled mean NT-proBNP levels on admission were 790.57 pg/mL (95% confidence intervals (CIs): 532.50 to 1048.64) in patients that experienced a severe clinical condition or died, and 160.56 pg/mL (95% CI: 118.15 to 202.96) in non-severe patients (SMD: 1.05; 95% (CI): 0.83 to 1.28; < 0.001; I 74%; and MD was 645.84 pg/mL (95% CI: 389.50-902.18). Results were consistent in studies categorizing patients as non-survivors versus survivors (SMD: 1.17; 95% CI 0.95 to 1.40; < 0. 001; I: 51%), and in those classifying populations in severe versus non-severe clinical condition (SMD: 0.94 95% CI 0.56 to 1.32; < 0.001; I: 81%; = 0.30). In conclusion, our results suggest that assessing NT-proBNP may support physicians in discriminating high-risk COVID-19 patients.
高达15%的2019冠状病毒病（COVID-19）患者会出现严重临床表现，导致急性呼吸窘迫综合征（ARDS）并最终死亡。N端脑钠肽（NT-proBNP）与ARDS患者的不良预后相关。然而，这种肽是否有助于鉴别高危COVID-19患者仍不清楚。因此，在这项荟萃分析中，我们总结了COVID-19住院患者中关于NT-proBNP的现有证据。汇总均值、均值差（MD）和标准化均值差（SMD）为汇总指标。最终选择了13项研究进行此项分析，共有2248例患者，其中507例病情严重（n = 240）或死亡（n = 267）。病情严重或死亡患者入院时NT-proBNP的汇总均值水平为790.57 pg/mL（95%置信区间（CI）：532.50至1048.64），非严重患者为160.56 pg/mL（95%CI：118.15至202.96）（SMD：1.05；95%（CI）：0.83至1.28；P<0.001；I² = 74%；MD为645.84 pg/mL（95%CI：389.50 - 902.18）。在将患者分类为非幸存者与幸存者的研究中（SMD：1.17；95%CI 0.95至1.40；P<0.001；I² = 51%）以及在将人群分类为严重与非严重临床状况的研究中（SMD：0.94；95%CI 0.56至1.32；P<0.001；I² = 81%；P = 0.30），结果是一致的。总之，我们的结果表明，评估NT-proBNP可能有助于医生鉴别高危COVID-19患者。
