• Am J Emerg Med · Oct 2020

    Elevated cardiac biomarkers may be effective prognostic predictors for patients with COVID-19: A multicenter, observational study.

    • Jie Yang, Xuelian Liao, Wanhong Yin, Bo Wang, Jirong Yue, Lang Bai, Dan Liu, Ting Zhu, Zhixin Huang, Yan Kang, and Study of 2019 Novel Coronavirus Pneumonia Infected Critically Ill Patients in Sichuan Province (SUNRISE) Group.
    • Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China.
    • Am J Emerg Med. 2020 Oct 13; 39: 344134-41.

    PurposeThe coronavirus disease 19 (COVID-19) has become a global health event. Cardiac biomarkers like creatine kinase isoenzyme (CK-MB), myoglobin, and high-sensitivity troponin T were usually elevated in early stages. This study aimed to investigate whether the elevated cardiac biomarkers could become effective prognostic predictors for COVID-19 patients.MethodsThe present study involved 357 COVID-19 patients. The potential predictors for two study outcomes (in-hospital death and recovery status) in 28 days were selected by LASSO regression analysis. Prognostic values of cardiac biomarkers selected were evaluated using the receiver operating characteristic curve (ROC) and the area under ROC (AUC).ResultsAfter 28-day follow-up, overall 357 patients were divided into death group (n = 25) and survival group (n = 332), or non-recovery group (n = 43) and recovery group (n = 314). The LASSO regression analysis showed elevated CK-MB and myoglobin were independent risk predictors for in-hospital death, and CK-MB and myoglobin were also independent risk predictors for non-recovery. The AUC of CK-MB and myoglobin for in-hospital death were 0.862 (95%CL: 0.804-0.920, p < 0.001) and 0.838 respectively (95%CL: 0.729-0.947, p < 0.001). The AUC of CK-MB and myoglobin for non-recovery were 0.839 (95%CL: 0.786-0.892, p < 0.001) and 0.841 (95%CL: 0.765-0.918, p < 0.001) respectively. We also found AUC of combined use of CK-MB and myoglobin for in-hospital death and non-recovery were 0.883 (95CL: 0.813-0.952, p < 0.001), and 0.873 (95%CL: 0.817-0.930, p < 0.001) respectively.ConclusionsIn patients with COVID-19, elevated CK-MB and myoglobin on admission may be effective predictors for adverse outcomes, and combined use of CK-MB and myoglobin had a better performance for prediction.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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