Division of Cardiology, The Department of Medicine and Center of Excellence for Cardiovascular Diseases & Sciences, Louisiana State University Health Sciences Center-Shreveport (LSUHSC-S), 1501 Kings Hwy, Shreveport, LA, 71103, USA.
Sci Rep. 2021 Mar 2;11(1):4930. doi: 10.1038/s41598-021-84643-6.
Multiple Biomarkers have recently been shown to be elevated in COVID-19, a respiratory infection with multi-organ dysfunction; however, information regarding the prognostic value of cardiac biomarkers as it relates to disease severity and cardiac injury are inconsistent. The goal of this meta-analysis was to summarize the evidence regarding the prognostic relevance of cardiac biomarkers from data available in published reports. PubMed, Embase and Web of Science were searched from inception through April 2020 for studies comparing median values of cardiac biomarkers in critically ill versus non-critically ill COVID-19 patients, or patients who died versus those who survived. The weighted mean differences (WMD) and 95% confidence interval (CI) between the groups were calculated for each study and combined using a random effects meta-analysis model. The odds ratio (OR) for mortality based on cardiac injury was combined from studies reporting it. Troponin levels were significantly higher in COVID-19 patients who died or were critically ill versus those who were alive or not critically ill (WMD 0.57, 95% CI 0.43-0.70, p < 0.001). Additionally, BNP levels were also significantly higher in patients who died or were critically ill (WMD 0.45, 95% CI - 0.21-0.69, p < 0.001). Cardiac injury was independently associated with significantly increased odds of mortality (OR 6.641, 95% CI 1.26-35.1, p = 0.03). A significant difference in levels of D-dimer was seen in those who died or were critically ill. CK levels were only significantly higher in those who died versus those who were alive (WMD 0.79, 95% CI 0.25-1.33, p = 0.004). Cardiac biomarkers add prognostic value to the determination of the severity of COVID-19 and can predict mortality.
多种生物标志物最近已被证明在 COVID-19 中升高，COVID-19 是一种具有多器官功能障碍的呼吸道感染；然而，关于心脏生物标志物与疾病严重程度和心脏损伤相关的预后价值的信息不一致。本荟萃分析的目的是总结已发表报告中有关心脏生物标志物预后相关性的证据。从 2020 年 4 月起，通过 PubMed、Embase 和 Web of Science 搜索比较危重症 COVID-19 患者与非危重症患者或死亡患者与存活患者心脏生物标志物中位数值的研究。计算每组研究的加权均数差值 (WMD) 和 95%置信区间 (CI)，并使用随机效应荟萃分析模型进行合并。报告心脏损伤的研究中，基于心脏损伤的死亡率的比值比 (OR) 进行了合并。与存活或非危重症患者相比，死亡或危重症 COVID-19 患者的肌钙蛋白水平明显更高 (WMD 0.57，95% CI 0.43-0.70，p<0.001)。此外，BNP 水平在死亡或危重症患者中也明显更高 (WMD 0.45，95% CI -0.21-0.69，p<0.001)。心脏损伤与死亡率显著增加独立相关 (OR 6.641，95% CI 1.26-35.1，p=0.03)。死亡或危重症患者的 D-二聚体水平有显著差异。与存活患者相比，只有死亡患者的 CK 水平明显更高 (WMD 0.79，95% CI 0.25-1.33，p=0.004)。心脏生物标志物增加了 COVID-19 严重程度的确定的预后价值，并可预测死亡率。
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