Adamescu Aida-Isabela, Tilișcan Cătălin, Stratan Laurențiu Mihăiță, Mihai Nicoleta, Ganea Oana-Alexandra, Ciobanu Sebastian, Marinescu Adrian Gabriel, Aramă Victoria, Aramă Ștefan Sorin
Department II, Pathophysiology and Immunology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Prof. Dr. Matei Bals National Institute of Infectious Diseases, 021105 Bucharest, Romania.
Biomedicines. 2025 Mar 10;13(3):672. doi: 10.3390/biomedicines13030672.
: COVID-19 has largely become an endemic disease in many regions, with sporadic outbreaks, with some areas where the disease shows a seasonal pattern like the influenza virus. The focus has shifted towards managing mild and moderate forms of disease through outpatient care, aiming to prevent healthcare system overload. Consequently, identifying markers that could be used in stratifying the risk and the prognostic assessment has become crucial. Cardiovascular implications of COVID-19 are a critical area of research due to their significant impact on disease severity, mortality, and morbidity. : We conducted a retrospective, observational study and included 472 patients, diagnosed with COVID-19, all of whom were admitted to Prof. Dr. Matei Bals National Institute of Infectious Disease, Bucharest, Romania. Levels of cardiac biomarkers like creatine kinase (CK), creatine kinase-myocardial band (CKMB), myoglobin, troponins, and NT-pro-BNP were measured and analyzed in relation to clinical presentation and outcomes. : We combined CKMB, myoglobin, and troponin I to predict hospital length of stay (LOS). Our model significantly predicted LOS (F = 12.537, = 0.0001), with higher levels associated with prolonged stays (β = 0.166, = 0.000). Logistic regression demonstrated that the combination of elevated CKMB and myoglobin levels significantly increased the odds of a longer LOS (OR = 1.679, = 0.000). Furthermore, we found significant correlations with acute respiratory failure ( = 0.001), severe forms of disease ( = 0.000), and the development of complications during hospitalization ( = 0.027). : These findings emphasize the value of combining cardiac biomarkers to stratify risk and predict hospital outcomes in COVID-19 patients. Routine cardiac monitoring and targeted management strategies could decrease the risk of complications, reducing the LOS. Our findings highlight the potential of cardiac biomarkers as prognostic tools to stratify risk, guide clinical interventions, and improve outcomes in COVID-19 patients.
在许多地区，新冠病毒病在很大程度上已成为一种地方性疾病，时有散发病例爆发，在一些地区，该疾病呈现出与流感病毒相似的季节性模式。重点已转向通过门诊护理来管理轻症和中症病例，旨在防止医疗系统不堪重负。因此，识别可用于风险分层和预后评估的标志物变得至关重要。由于新冠病毒病对疾病严重程度、死亡率和发病率有重大影响，其心血管方面的影响是一个关键的研究领域。我们进行了一项回顾性观察研究，纳入了472例被诊断为新冠病毒病的患者，他们均入住罗马尼亚布加勒斯特的马泰·巴尔什国立传染病研究所。测量并分析了肌酸激酶（CK）、肌酸激酶同工酶（CKMB）、肌红蛋白、肌钙蛋白和N末端脑钠肽前体（NT-pro-BNP）等心脏生物标志物的水平，并将其与临床表现和预后相关联。我们将CKMB、肌红蛋白和肌钙蛋白I结合起来预测住院时间（LOS）。我们的模型显著预测了住院时间（F = 12.537，P = 0.0001），水平越高，住院时间越长（β = 0.166，P = 0.000）。逻辑回归表明，CKMB和肌红蛋白水平升高的组合显著增加了住院时间延长的几率（OR = 1.679，P = 0.000）。此外，我们发现其与急性呼吸衰竭（P = 0.001）、重症疾病（P = 0.000）以及住院期间并发症的发生（P = 0.027）存在显著相关性。这些发现强调了联合使用心脏生物标志物对新冠病毒病患者进行风险分层和预测医院预后的价值。常规心脏监测和针对性管理策略可降低并发症风险，缩短住院时间。我们的发现凸显了心脏生物标志物作为预后工具在新冠病毒病患者中进行风险分层、指导临床干预和改善预后的潜力。
