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Analysis of heart injury laboratory parameters in 273 COVID-19 patients in one hospital in Wuhan, China

Our take —

Among a group of Chinese inpatients with COVID-19, cardiac biomarkers were commonly elevated, and were more frequently abnormal in those with severe clinical illness. However, this study provides insufficient evidence for the utility of cardiac biomarkers as a prognostic value in patients with COVID-19.

Study design

Retrospective Cohort

Study population and setting

The study population was comprised of 273 patients with laboratory-confirmed SARS-CoV-2 infection from a single hospital in Wuhan, China who were admitted between January 1, 2020 and February 18, 2020. Among these patients, 198 were classified as having mild clinical disease, 60 with severe disease, and 15 with critical disease.

Summary of Main Findings

At admission, 12% of patients presented with elevated levels of brain natriuretic peptide (NT-proBNP), 10% with elevated myoglobin, 10% with elevated troponin I, and 4% with elevated creatinine kinase (CK-MB). Of the biomarkers, myoglobin, troponin I, and NT-proBNP appear to be differentially elevated with more severe illness presentations. Patients presenting with abnormal cardiac laboratory parameters had more than four times the mortality ratio as those without (23% vs. 5%).

Study Strengths

N/A

Limitations

As there are no data presented on pre-infection health and comorbidities of participants, it is not possible to attribute the rise in cardiac biomarkers to the infection. This is particularly true with high-sensitivity troponin and BNP assays that may be chronically elevated. There is no information presented on the prognostic utility of specific threshold biomarker values. Further, cardiac biomarkers may be elevated in the setting of hypoxia or shock; there is insufficient information presented to allow for the evaluation of the prognostic role of isolated cardiac biomarkers.

Value added

This study presents data on cardiac injury biomarkers in a reasonably large study population of patients with COVID-19.