Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study

Abstract. Background. The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 in India has been declared a public health emergency. Many patients with COVID-19 experience cardiac injury. Patients with COVID-19 admitted to the intensive care unit...

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Main Authors: Neeraj Kumar, Sarfaraz Ahmad, Mala Mahto, Abhyuday Kumar, Prabhat K. Singh
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2022-09-01
Series:Emergency and Critical Care Medicine
Online Access:http://journals.lww.com/10.1097/EC9.0000000000000057
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author Neeraj Kumar
Sarfaraz Ahmad
Mala Mahto
Abhyuday Kumar
Prabhat K. Singh
author_facet Neeraj Kumar
Sarfaraz Ahmad
Mala Mahto
Abhyuday Kumar
Prabhat K. Singh
author_sort Neeraj Kumar
collection DOAJ
description Abstract. Background. The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 in India has been declared a public health emergency. Many patients with COVID-19 experience cardiac injury. Patients with COVID-19 admitted to the intensive care unit (ICU) with acute myocardial injury showed increased high-sensitivity troponin levels. Abnormal troponin levels may indicate myocardial injury and are commonly associated with COVID-19. Methods. We conducted a retrospective observational study of 44 patients with severe COVID-19 in ICU during the second wave. The primary end point of our retrospective study was 28-day mortality, and the time of ICU admission was designated as day 0. We extracted and analyzed cardiac biomarkers, such as creatine kinase (CK), creatine kinase-MB (CK-MB), B-type natriuretic peptide (BNP), and high-sensitivity cardiac troponin I (hs-cTnI), and various inflammatory markers such as C-reactive protein (CRP) level, interleukin 6 (IL-6), d-dimer, ferritin, lactate dehydrogenase, IL-6, and procalcitonin in patients with severe COVID-19 at ICU admission and 72 hours after ICU admission from our electronic medical record system. Results. The best cutoff of BNP were 326.8 and 398.5 pg/mL, CK were 195.95 and 180.12 U/L, CK-MB were 112.10 and 108.5 U/L, and hs-cTnI were 0.035 and 0.025 ng/mL, at ICU admission and 72 hours after ICU admission for predicting 28-day mortality among nonsurvivors. Conclusion. In patients with severe COVID-19, CK and hs-cTnI may be considered effective and valuable predictive cardiac biomarkers among nonsurvivors and predict poor prognosis.
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spelling doaj-art-8f237cd2cc6c4ccbbcf7aec8cce8bc172025-08-20T03:17:55ZengWolters Kluwer Health/LWWEmergency and Critical Care Medicine2097-06172693-860X2022-09-012312212710.1097/EC9.0000000000000057202209000-00005Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective studyNeeraj Kumar0Sarfaraz Ahmad1Mala Mahto2Abhyuday Kumar3Prabhat K. Singh4a Department of Trauma and Emergency, All India Institute of Medical Sciences Patna, Bihar, Indiab Department of Anaesthesiology, All India Institute of Medical Sciences Patna, Bihar, Indiac Department of Biochemistry, All India Institute of Medical Sciences Patna, Bihar, Indiab Department of Anaesthesiology, All India Institute of Medical Sciences Patna, Bihar, Indiad Director, All India Institute of Medical Sciences Patna, Bihar, India.Abstract. Background. The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 in India has been declared a public health emergency. Many patients with COVID-19 experience cardiac injury. Patients with COVID-19 admitted to the intensive care unit (ICU) with acute myocardial injury showed increased high-sensitivity troponin levels. Abnormal troponin levels may indicate myocardial injury and are commonly associated with COVID-19. Methods. We conducted a retrospective observational study of 44 patients with severe COVID-19 in ICU during the second wave. The primary end point of our retrospective study was 28-day mortality, and the time of ICU admission was designated as day 0. We extracted and analyzed cardiac biomarkers, such as creatine kinase (CK), creatine kinase-MB (CK-MB), B-type natriuretic peptide (BNP), and high-sensitivity cardiac troponin I (hs-cTnI), and various inflammatory markers such as C-reactive protein (CRP) level, interleukin 6 (IL-6), d-dimer, ferritin, lactate dehydrogenase, IL-6, and procalcitonin in patients with severe COVID-19 at ICU admission and 72 hours after ICU admission from our electronic medical record system. Results. The best cutoff of BNP were 326.8 and 398.5 pg/mL, CK were 195.95 and 180.12 U/L, CK-MB were 112.10 and 108.5 U/L, and hs-cTnI were 0.035 and 0.025 ng/mL, at ICU admission and 72 hours after ICU admission for predicting 28-day mortality among nonsurvivors. Conclusion. In patients with severe COVID-19, CK and hs-cTnI may be considered effective and valuable predictive cardiac biomarkers among nonsurvivors and predict poor prognosis.http://journals.lww.com/10.1097/EC9.0000000000000057
spellingShingle Neeraj Kumar
Sarfaraz Ahmad
Mala Mahto
Abhyuday Kumar
Prabhat K. Singh
Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study
Emergency and Critical Care Medicine
title Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study
title_full Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study
title_fullStr Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study
title_full_unstemmed Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study
title_short Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study
title_sort prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe covid 19 a single center retrospective study
url http://journals.lww.com/10.1097/EC9.0000000000000057
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