The role of concomitant cardiovascular diseases and cardiac biomarkers for predicting mortality in critical COVID-19 patients

Abstract

Background

to identify the potential cardiovascular risk factors associated with mortality in hospitalised COVID-19 patients.

Methods

All consecutive patients admitted to intensive care unit (ICU) of our institute for COVID-19 from 1 April 2020 to 20 May 2020 were included. Patient characteristics including complete medical history and comorbid diseases, admission and 7th day blood test results and clinical characteristics were compared between survivors and non-survivors.

Results

There were no significant difference between survivors and non-survivors regarding age, gender, and pre-existing coronary artery disease, hypertension, diabetes, heart failure, coronary artery bypass grafting surgery, percutaneous coronary intervention and coronary stenting. Admission D-dimer and NT-proBNP levels of non-survivors were significantly higher than survivors. CRP, procalcitonin, creatine kinase (CK) and troponin I levels on 7th day of admission were significantly higher in non-survivors compared to survivors. In addition, both admission and 7th day lymphocyte count were lower in non-survivors compared to that of the survivors. CRP declined from admission to 7th day of hospitalisation in survivors, whereas a median 6.75 mg/L increase was observed in non survivors. The peak and minimum CRP, procalcitonin and levels were significantly higher in non-survivors than survivors. The peak NT-proBNP level of non-survivors was also significantly higher than that of the survivors. Intubation, lower GFR values and higher NT-proBNP values were predictive for death.

Conclusion

The prothrombotic coagulopathy mediated by the endothelial interaction with SARS-CoV-2 may also have role in unfavourable prognosis in COVID-19. These readily available biomarkers might be useful in risk stratification of COVID-19 cases.

Keywords:

• COVID-19
• cardiovascular disease
• cardiac injury
• biomarker

Disclosure statement

No potential conflict of interest was reported by the authors.

What’s new?

Cardiac biomarkers including troponin I and NT-proBNP were higher in non-survivors compared to survivors indicating acute myocardial injury may have role on poor outcomes in COVID-19 patients. Admission D-dimer level was also higher among non-survivors compared to that of the survivors. The prothrombotic coagulopathy mediated by the endothelial interaction with SARS-CoV-2 may also have role in unfavourable prognosis in COVID-19. These readily available biomarkers might be useful in risk stratification of COVID-19 cases.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.