Weng Haoyu, Yang Fan, Zhang Long, Jin Han, Liu Shengcong, Fan Fangfang, Liu Zhihao, Zheng Xizi, Yang Hongyu, Li Yuxi, Yi Tieci, Li Haichao, Zhang Yan, Li Jianping
Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China.
Department of Nephrology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China.
J Transl Int Med. 2021 Sep 28;9(3):177-184. doi: 10.2478/jtim-2021-0034. eCollection 2021 Sep.
The pandemic of coronavirus disease 2019 (COVID-19) remains to be the biggest public threat all over the world. Because of the rapid deterioration in some patients, markers that could predict poor clinical outcomes are urgently required. This study was to evaluate the predictive values of cardiac injury parameters, including cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, on mortality in COVID-19 patients.
COVID-19 patients in Zhongfaxincheng branch of Tongji Hospital (Wuhan, China) from February 8-28, 2020, were enrolled in this study. We followed up the patients for 30 days after admission.
A total of 134 patients were included in the study. Multivariate Cox regression showed that 1) patients with elevated cTnI levels had a higher risk of death (hazard ratio [HR] 7.33, 95% confidence interval [CI] 2.56-21.00) than patients with normal cTnI levels; 2) patients with elevated NT-proBNP levels had a higher risk of death (HR 27.88, 95% CI 3.55-218.78) than patients with normal NT-proBNP levels; 3) patients with both elevated cTnI and NT-proBNP levels had a significantly higher risk of death (HR 53.87, 95% CI 6.31-459.91, < 0.001) compared to patients without elevated cTnI or NT-proBNP levels; 4) the progressions of cTnI and NT-proBNP levels were also correlated with death (HR 12.70, 95% CI 3.94-40.88, < 0.001 and HR 51.09, 95% CI 5.82-448.26, < 0.001).
In COVID-19 patients, cTnI and NT-proBNP levels could be monitored to identify patients at a high risk of death in their later course of disease.
2019冠状病毒病（COVID-19）大流行仍是全球最大的公共卫生威胁。由于部分患者病情迅速恶化，迫切需要能够预测不良临床结局的标志物。本研究旨在评估心脏损伤参数，包括心肌肌钙蛋白I（cTnI）和N末端B型利钠肽原（NT-proBNP）水平，对COVID-19患者死亡率的预测价值。
选取2020年2月8日至28日在武汉同济医院中法新城院区的COVID-19患者纳入本研究。患者入院后随访30天。
本研究共纳入134例患者。多因素Cox回归分析显示：1）cTnI水平升高的患者死亡风险高于cTnI水平正常的患者（风险比[HR] 7.33，95%置信区间[CI] 2.56 - 21.00）；2）NT-proBNP水平升高的患者死亡风险高于NT-proBNP水平正常的患者（HR 27.88，95% CI 3.55 - 218.78）；3）cTnI和NT-proBNP水平均升高的患者死亡风险显著高于cTnI或NT-proBNP水平未升高的患者（HR 53.87，95% CI 6.31 - 459.91，<0.001）；4）cTnI和NT-proBNP水平的变化也与死亡相关（HR 12.70，95% CI 3.94 - 40.88，<0.001和HR 51.09，95% CI 5.82 - 448.26，<0.001）。
在COVID-19患者中，可监测cTnI和NT-proBNP水平，以识别疾病后期死亡风险较高的患者。
