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Park M, Hur M, Kim H, Lee CH, Lee JH, Kim HW, Nam M, Lee S. Soluble ST2 as a Useful Biomarker for Predicting Clinical Outcomes in Hospitalized COVID-19 Patients. Diagnostics (Basel) 2023; 13:diagnostics13020259. [PMID: 36673069 PMCID: PMC9857572 DOI: 10.3390/diagnostics13020259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/31/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
Soluble suppression of tumorigenesis-2 (sST2) is an emerging biomarker for sepsis as well as for heart failure. We investigated the prognostic utility of sST2 for predicting clinical outcomes in hospitalized coronavirus disease 2019 (COVID-19) patients. In a total of 52 hospitalized COVID-19 patients, sST2 levels were measured using the ichroma ST2 assay (Boditech Med Inc., Chuncheon-si, Gang-won-do, Republic of Korea). Clinical outcomes included intensive care unit (ICU) admission, ventilator use, extracorporeal membrane oxygenation (ECMO) use, and 30-day mortality. sST2 was analyzed according to clinical outcomes. sST2, sequential organ failure assessment (SOFA) score, critical disease, and 4C mortality score were compared using the receiver operating characteristic (ROC) curve and Kaplan−Meier methods for clinical outcomes. The sST2 level differed significantly according to ICU admission, ventilator use, ECMO use, and 30-day mortality (all p < 0.05). On ROC curve analysis, sST2 predicted ICU admission, ventilator use, ECMO use, and 30-day mortality comparable to SOFA score but significantly better than critical disease. sST2 predicted ICU admission, ventilator use, and ECMO use significantly better than the 4C mortality score. On Kaplan−Meier survival analysis, hazard ratios (95% confidence interval) were 8.4 (2.7−26.8) for sST2, 14.8 (3.0−71.7) for SOFA score, 1.8 (0.5−6.5) for critical disease, and 11.7 (3.4−40.1) for 4C mortality score. This study demonstrated that sST2 could be a useful biomarker to predict ICU admission, ventilator use, ECMO use, and 30-day mortality in hospitalized COVID-19 patients. sST2 may be implemented as a prognostic COVID-19 biomarker in clinical practice.
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Affiliation(s)
- Mikyoung Park
- Department of Laboratory Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Mina Hur
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
- Correspondence: ; Tel.: +82-2-2030-5581
| | - Hanah Kim
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Chae Hoon Lee
- Department of Laboratory Medicine, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea
| | - Jong Ho Lee
- Department of Laboratory Medicine, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea
| | - Hyung Woo Kim
- Department of Laboratory Medicine, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea
| | - Minjeong Nam
- Department of Laboratory Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Seungho Lee
- Department of Preventive Medicine, College of Medicine, Dong-A University, Busan 49201, Republic of Korea
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Keefe JA, Avadhanula V, Nicholson EG, Devaraj S, Piedra PA, Bozkurt B, Wehrens XH. Abnormalities in cardiac and inflammatory biomarkers in ambulatory subjects after COVID-19 infection. IJC HEART & VASCULATURE 2022; 43:101144. [PMID: 36321063 PMCID: PMC9613792 DOI: 10.1016/j.ijcha.2022.101144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
Background Coronavirus-2019 (COVID-19) is known to affect the heart and is associated with a pro-inflammatory state. Most studies to date have focused on clinically sick subjects. Here, we report cardiac and proinflammatory biomarkers levels in ambulatory young adults with asymptomatic or mild COVID-19 infection compared to those without infection 4-8 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) testing. Methods 131 asymptomatic or mildly symptomatic subjects were enrolled following testing for SARS-COV-2. Fifty subjects tested negative, and 81 subjects tested positive. Serum samples were collected for measurement of C-reactive protein, ferritin, interleukin-6, NT-pro-B-type natriuretic peptide, and cardiac troponin 28-55 days after SARS-COV-2 RT-PCR testing. Results Biomarker levels trended higher in SARS-COV-2-positive vs negative subjects, but differences in biomarker levels or proportion of subjects with elevated biomarkers were not statistically significant with respect to SARS-COV-2 status. Among individuals with ≥ 1 comorbidity, odds of elevated CRP were greater compared to individuals without any comorbidities (odds ratio [OR] = 2.90); this effect size was increased 1.4-fold among SARS-COV-2-positive subjects (OR = 4.03). Similarly, NT-pro-BNP was associated with CVD, with the strongest association in COVID-positive individuals (OR = 16.9). Conclusions In a relatively young, healthy adult population, mild COVID-19 infection was associated with mild elevations in cardiac and proinflammatory biomarkers within 4-8 weeks of mild or asymptomatic COVID-19 infection in individuals with preexisting comorbidities, but not among individuals without comorbidities. For the general population of young adults, we did not find evidence of elevation of cardiac or proinflammatory biomarkers 4-8 weeks after COVID-19 infection.Clinical Perspective: This is a characterization of cardiac and proinflammatory biomarkers in ambulatory subjects following asymptomatic or mild COVID-19 infection. Young, ambulatory individuals did not have cardiac and proinflammatory biomarker elevation 4-8 weeks after mild COVID-19 infection. However, COVID-19 infection was associated with biomarker elevations in select individuals with comorbidities.Clinical study number: H-47423.
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Affiliation(s)
- Joshua A. Keefe
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Vasanthi Avadhanula
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Erin G. Nicholson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sridevi Devaraj
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Pedro A. Piedra
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Biykem Bozkurt
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Xander H.T. Wehrens
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
- Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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Markers of Infection-Mediated Cardiac Damage in Influenza and COVID-19. Pathogens 2022; 11:pathogens11101191. [PMID: 36297248 PMCID: PMC9607279 DOI: 10.3390/pathogens11101191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/18/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction: Influenza and the coronavirus disease 2019 (COVID-19) are two potentially severe viral infections causing significant morbidity and mortality. The causative viruses, influenza A/B and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) can cause both pulmonary and extra-pulmonary disease, including cardiovascular involvement. The objective of this study was to determine the levels of cardiac biomarkers in hospitalized patients infected with influenza or COVID-19 and their correlation with secondary outcomes. Methods: We performed a retrospective comparative analysis of cardiac biomarkers in patients hospitalized at our department with influenza or COVID-19 by measuring high-sensitivity troponin-T (hs-TnT) and creatinine kinase (CK) in plasma. Secondary outcomes were intensive care unit (ICU) admission and all-cause in-hospital mortality. Results: We analyzed the data of 250 influenza patients and 366 COVID-19 patients. 58.6% of patients with influenza and 46.2% of patients with COVID-19 presented with increased hs-TnT levels. Patients of both groups with increased hs-TnT levels were significantly more likely to require ICU treatment or to die during their hospital stay. Compared with COVID-19, cardiac biomarkers were significantly higher in patients affected by influenza of all age groups, regardless of pre-existing cardiovascular disease. In patients aged under 65 years, no significant difference in ICU admission and mortality was detected between influenza and COVID-19, whereas significantly more COVID-19 patients 65 years or older died or required intensive care treatment. Conclusions: Our study shows that increased cardiac biomarkers are associated with higher mortality and ICU admission in both, influenza and SARS-CoV-2-infected patients. Cardiac biomarkers are higher in the influenza cohort; however, this does not translate into worse outcomes when compared with the COVID-19 cohort.
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Lionte C, Sorodoc V, Haliga RE, Bologa C, Ceasovschih A, Sirbu O, Gorciac V, Chelariu AC, Stoica A, Tocila RE, Badescu MC, Costache II, Sandu CB, Jaba E, Sorodoc L. Cardiac Biomarkers and Risk Scores in Relation with History of Atherosclerotic Cardiovascular Disease in Patients Admitted with COVID-19: The Experience of an Eastern European Center. J Clin Med 2022; 11:5671. [PMID: 36233539 PMCID: PMC9571947 DOI: 10.3390/jcm11195671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Data regarding the combined prognostic role of biomarkers and risk scores in relation with the history of atherosclerotic cardiovascular disease (ASCVD) in COVID-19 patients are lacking. METHODS The aim of this observational cohort study was to evaluate the combined prognostic value of N-terminal pro B-type natriuretic peptide (NT-pro BNP), troponin and risk scores in relation with ASCVD history in hospitalized COVID-19 patients. The primary composite endpoint was Intensive Care Unit (ICU) admission and death. RESULTS From April 2020 to June 2022, 1066 consecutive COVID-19 patients with available biomarkers upon admission were included. During a median follow-up period of 12 days, 176 patients (16.5%) died. Independent predictors of ICU admission and death in patients with ASCVD were NT-pro BNP (HR 2.63; 95% CI, 1.65-4.18) and troponin (HR 1.51; 95% CI, 1.13-2.03). In patients without ASCVD, only NT-pro BNP was predictive for the primary endpoint (HR 1.66; 95% CI, 1.10-2.53). This remained significant after adjustment for other relevant covariates (HR 3.54; 95% CI, 1.98-6.33) in patients with ASCVD and in patients without ASCVD (HR 1.82; 95% CI, 1.02-3.26). CONCLUSIONS These data showed the combined prognostic accuracy of NT-pro BNP and troponin in relation with ASCVD history for ICU admission and death in COVID-19 patients.
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Affiliation(s)
- Catalina Lionte
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Victorita Sorodoc
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Raluca Ecaterina Haliga
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Cristina Bologa
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Alexandr Ceasovschih
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Oana Sirbu
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Victoria Gorciac
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
- Rheumatology Department, Clinical Recovery Hospital, 700661 Iasi, Romania
| | - Andrei-Costin Chelariu
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
- Hematology Department, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Alexandra Stoica
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
| | - Roxana Elena Tocila
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
- Department of Cardiology, Cardiovascular Diseases Institute “Prof. Dr. George I.M. Georgescu”, 700503 Iasi, Romania
| | - Minerva Codruta Badescu
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- III Internal Medicine Clinic, “St. Spiridon” County Emergency Clinical Hospital, 1 Independence Boulevard, 700111 Iasi, Romania
| | - Irina-Iuliana Costache
- Department of Internal Medicine (Cardiology), “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Christiana Brigitte Sandu
- Statistics Department, Faculty of Economics and Business Administration, “Alexandru Ioan Cuza” University, 700506 Iasi, Romania
| | - Elisabeta Jaba
- Statistics Department, Faculty of Economics and Business Administration, “Alexandru Ioan Cuza” University, 700506 Iasi, Romania
| | - Laurentiu Sorodoc
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700106 Iasi, Romania
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Ogungbe O, Commodore-Mensah Y, Dennison Himmelfarb CR, Ferguson C, Martin K, Davidson PM. COVID-19: Lessons Learned and a Need for Data Driven Decision Making. Heart Lung Circ 2022; 31:905-909. [PMID: 35752453 PMCID: PMC9221316 DOI: 10.1016/j.hlc.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cheryl R Dennison Himmelfarb
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Keith Martin
- Consortium of Universities for Global Health, Washington, DC, VA, USA
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; University of Wollongong, Wollongong, NSW, Australia; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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Lionte C, Sorodoc V, Haliga RE, Bologa C, Ceasovschih A, Petris OR, Coman AE, Stoica A, Sirbu O, Puha G, Constantin M, Dumitrescu G, Gorciac V, Chelariu AC, Catana AN, Jaba E, Sorodoc L. Inflammatory and Cardiac Biomarkers in Relation with Post-Acute COVID-19 and Mortality: What We Know after Successive Pandemic Waves. Diagnostics (Basel) 2022; 12:1373. [PMID: 35741183 PMCID: PMC9222082 DOI: 10.3390/diagnostics12061373] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Biomarkers were correlated with mortality in critically ill COVID-19 patients. No prediction tools exist for noncritically ill COVID-19 patients. We aimed to compare the independent prognostic value of inflammation and cardiac biomarkers for post-acute COVID-19 patients and the 30-day mortality rate in noncritically ill COVID-19 patients, as well as the relation with the virus variant involved. METHODS This observational cohort study was conducted at an emergency clinical hospital between 1 October 2020 and 31 December 2021. We included consecutive patients with biomarkers determined within 24 h of presentation, followed up at least 30 days postdischarge. RESULTS Post-acute COVID-19 was diagnosed in 20.3% of the cases and the all-cause 30-day mortality rate was 35.1% among 978 patients infected with variants of concern. Neutrophil-to-lymphocyte ratio (1.06 [95%CI, 1.01-1.11], p = 0.015) and NT-pro BNP were correlated with 30-daymortality, while the monocyte-to-lymphocyte ratio (2.77 [95%CI, 1.10-6.94], p = 0.03) and NT-pro BNP (1.68 [95%CI, 1.00-2.84], p = 0.05) were correlated with post-acute COVID-19. High-sensitivity to troponin was associated with 30-day mortality (1.55 [95%CI, 1.00-2.42], p = 0.05). A Cox proportional-hazards model confirmed that NT-pro BNP was independently associated with mortality. NT-pro BNP remained independently associated with 30-day mortality during follow-up (1.29 [95%CI, 1.07-1.56], p = 0.007) after adjustment for confounders. CONCLUSION Inflammation and cardiac biomarkers, determined upon admission and predischarge, in a cohort of hospitalized noncritically ill COVID-19 patients throughout successive pandemic waves, showed a predictive value for post-acute COVID-19 and 30-day mortality.
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Affiliation(s)
- Catalina Lionte
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Victorita Sorodoc
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Raluca Ecaterina Haliga
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Cristina Bologa
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Alexandr Ceasovschih
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Ovidiu Rusalim Petris
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
- Nursing Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Adorata Elena Coman
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
- Preventive Medicine and Interdisciplinarity Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandra Stoica
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Oana Sirbu
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Gabriela Puha
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Mihai Constantin
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Gabriela Dumitrescu
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
| | - Victoria Gorciac
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
- Rheumatology Department, Clinical Recovery Hospital, 700661 Iasi, Romania
| | - Andrei-Costin Chelariu
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
- Hematology Department, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Andreea Nicoleta Catana
- Infectious Disease Compartment, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania;
| | - Elisabeta Jaba
- Statistics Department, FEEA, “Alexandru Ioan Cuza” University, 700506 Iasi, Romania;
| | - Laurentiu Sorodoc
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (R.E.H.); (C.B.); (A.S.); (O.S.); (G.P.); (M.C.); (G.D.); (L.S.)
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania; (O.R.P.); (A.E.C.); (V.G.); (A.-C.C.)
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Ogungbe O, Kumbe B, Fadodun OA, Latha T, Meyer D, Asala AF, Davidson PM, Dennison Himmelfarb CR, Post WS, Commodore-Mensah Y. Subclinical myocardial injury, coagulopathy, and inflammation in COVID-19: A meta-analysis of 41,013 hospitalized patients. IJC HEART & VASCULATURE 2022; 40:100950. [PMID: 35005211 PMCID: PMC8723832 DOI: 10.1016/j.ijcha.2021.100950] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/08/2021] [Accepted: 12/29/2021] [Indexed: 12/24/2022]
Abstract
Background Infection with the SARS-CoV-2 virus can lead to myocardial injury, evidenced by increases in specific biomarkers and imaging. Objective To quantify the association between biomarkers of myocardial injury, coagulation, and severe COVID-19 and death in hospitalized patients. Methods Studies were identified through a systematic search of indexed articles in PubMed, Embase, CINAHL, Cochrane, Web of Science, and Scopus, published between December 2019 to August 2021. Effect estimates from individual studies for association between markers of myocardial injury (Troponin), myocardial stretch (N-terminal-pro hormone BNP, NT-proBNP), and coagulopathy (D-Dimer) and death or severe/critical COVID-19 were pooled using inverse variance weighted random-effects model. Odds Ratios (OR), Hazard Ratios (HR), and 95% Confidence Intervals (CI) were pooled separately and reported by outcomes of critical/severe COVID-19 and death. A meta-analysis of proportions was also performed to summarize the pooled prevalence of co-morbidities in patients hospitalized with COVID-19. Results We included 62 articles, with a total of 41,013 patients. The pooled proportion of patients with history of hypertension was 39% (95% CI: 34-44%); diabetes, 21% (95% CI: 18%-24%); coronary artery disease, 13% (95% CI: 10-16%); chronic obstructive pulmonary disease, 7% (95% CI: 5-8%); and history of cancer, 5% (95% CI: 4-7%). Elevated troponin was associated with higher pooled odds of critical/severe COVID-19 and death [Odds Ratio (OR: 1.76, 95% CI: 1.42-2.16)]; and also separately for death (OR: 1.72, 95% CI: 1.32-2.25), and critical/severe COVID-1919 (OR: 1.93, 95% CI: 1.45-2.40). Elevations in NT-proBNP were also associated with higher severe COVID-19 and death (OR: 3.00, 95% CI: 1.58-5.70). Increases in D-dimer levels was also significantly associated with critical/severe COVID-19 and death (pooled OR: 1.38, 95% CI: 1.07-1.79). Conclusions This meta-analysis synthesizes existing evidence showing that myocardial injury, and coagulopathy are complications of COVID-19. The durability of these complications and their contributions to long-term cardiac implications of the disease is still being investigated. Patients who have recovered from COVID-19 may benefit from minimally invasive assessment for markers of myocardial injury, stretch and coagulopathy for early risk stratification purposes.
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Affiliation(s)
| | - Baridosia Kumbe
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | - T. Latha
- Manipal Academy of Higher Education, Manipal, India
| | - Diane Meyer
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Patricia M. Davidson
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
- University of Wollongong, Wollongong, Australia
| | - Cheryl R. Dennison Himmelfarb
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Wendy S. Post
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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8
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Chen CH, Lin SW, Shen CF, Hsieh KS, Cheng CM. Biomarkers during COVID-19: Mechanisms of Change and Implications for Patient Outcomes. Diagnostics (Basel) 2022; 12:509. [PMID: 35204599 PMCID: PMC8870804 DOI: 10.3390/diagnostics12020509] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 01/08/2023] Open
Abstract
As the COVID-19 (Coronavirus disease 19) pandemic spreads worldwide, the massive numbers of COVID-19 patients have created a considerable healthcare burden for every country. The clinical spectrum of SARS-CoV-2 infection is broad, ranging from asymptomatic to mild, moderate, severe, and critical. Most COVID-19 patients present with no or mild symptoms, but nearly one-fifth of all patients develop severe or life-threatening complications. In addition to localized respiratory manifestations, severe COVID-19 cases also show extra-pulmonary complications or induce multiorgan failure. Identifying, triaging, and treating patients at risk early is essential and urgent. This article reviews the potential prognostic value of various biomarkers at different clinical spectrum stages of COVID-19 infection and includes information on fundamental prognostic mechanisms as well as potential clinical implications. Biomarkers are measurable biochemical substances used to recognize and indicate disease severity or response to therapeutic interventions. The information they provide is objective and suitable for delivering healthcare providers with a means of stratifying disease state in COVID-19 patients. This, in turn, can be used to help select and guide intervention efforts as well as gauge the efficacy of therapeutic approaches. Here, we review a number of potential biomarkers that may be used to guide treatment, monitor treatment efficacy, and form individualized therapeutic guidance based on patient response. Implementation of the COVID-19 biomarkers discussed here may lead to significantly improved quality of care and patient outcomes for those infected with SARS-CoV-2 worldwide.
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Affiliation(s)
- Cheng-Han Chen
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan; (C.-H.C.); (S.-W.L.)
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Sheng-Wen Lin
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan; (C.-H.C.); (S.-W.L.)
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Kai-Sheng Hsieh
- Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, Taipei 23561, Taiwan
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan; (C.-H.C.); (S.-W.L.)
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9
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Alcaide E, Álvarez Bota L, Salas R. Relevance of myocardial injury biomarkers to the prognosis of COVID-19 patients. REVISTA ESPAÑOLA DE CARDIOLOGÍA (ENGLISH EDITION) 2022; 75:105. [PMID: 34565698 PMCID: PMC8403660 DOI: 10.1016/j.rec.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Eric Alcaide
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
| | | | - Rosario Salas
- Servicio de Medicina Interna, Hospital Universitari Sagrat Cor-Grupo Quirónsalud, Barcelona, Spain
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10
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Alcaide E, Bota LÁ, Salas R. [Relevance of myocardial injury biomarkers to the prognosis of COVID-19 patients]. Rev Esp Cardiol 2021; 75:105. [PMID: 34334881 PMCID: PMC8302830 DOI: 10.1016/j.recesp.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Eric Alcaide
- Departament de Medicina, Universitat de Barcelona, Barcelona, España
| | - Laia Álvarez Bota
- Departament de Medicina, Universitat de Barcelona, Barcelona, España
| | - Rosario Salas
- Servicio de Medicina Interna, Hospital Universitari Sagrat Cor-Grupo Quirónsalud, Barcelona, España
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Dahiya T, Yadav S, Yadav N, Mann A, Sharma M, Rana J. Monitoring of BNP cardiac biomarker with major emphasis on biosensing methods: A review. SENSORS INTERNATIONAL 2021. [DOI: 10.1016/j.sintl.2021.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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