Key result
Elevated cardiac biomarkers, such as cardiac troponin I, were significantly associated with increased COVID-19 severity (SMD 0.81; 95% CI 0.14-1.48; P=0.017) and mortality.
Why the study?
To systematically investigate the relationship between cardiac biomarkers and COVID-19 severity and mortality.
Are elevated cardiac biomarkers associated with increased severity and mortality in patients with COVID-19?
Meta-Analysis (n=9,532)
Are elevated cardiac biomarkers associated with increased severity and mortality in patients with COVID-19?
Standardized Mean Difference: 0.81 (95% CI 0.14–1.48)
p-value: p=0.017
Elevated cardiac biomarkers, including troponins, CK-MB, and myoglobin, are significantly associated with increased disease severity and mortality in patients with COVID-19, highlighting their utility for risk stratification.
May aid COVID-19 risk stratification; confirms biomarker-outcome association across pooled studies.
OBJECTIVE: To systematically investigate the relationship between cardiac biomarkers and COVID-19 severity and mortality. METHODS: We performed a literature search using PubMed, Web of Science, and Google Scholar. The standardized mean difference (SMD) and 95% confidence interval (CI) were applied to estimate the combined results of 67 studies. A meta-analysis of cardiac biomarkers was used to evaluate disease mortality and severity in COVID-19 patients. RESULTS: A meta-analysis of 7812 patients revealed that patients with high levels of cardiac troponin I (SMD = 0.81 U/L, 95% CI = 0.14-1.48, P = 0.017), cardiac troponin T (SMD = 0.78 U/L, 95% CI = 0.07-1.49, P = 0.032), high-sensitive cardiac troponin I (SMD = 0.66 pg/mL, 95% CI = 0.51-0.81, P < 0.001), high-sensitive cardiac troponin T (SMD = 0.93 U/L, 95% CI = 0.21-1.65, P = 0.012), creatine kinase-MB (SMD = 0.54 U/L, 95% CI = 0.39-0.69, P < 0.001), and myoglobin (SMD = 0.80 U/L, 95% CI = 0.57-1.03, P < 0.001) were associated with prominent disease severity in COVID-19 infection. Moreover, 9532 patients with a higher serum level of cardiac troponin I (SMD = 0.51 U/L, 95% CI = 0.37-0.64, P < 0.001), high-sensitive cardiac troponin (SMD = 0.51 ng/L, 95% CI = 0.29-0.73, P < 0.001), high-sensitive cardiac troponin I (SMD = 0.51 pg/mL, 95% CI = 0.38-0.63, P < 0.001), high-sensitive cardiac troponin T (SMD = 0.85 U/L, 95% CI = 0.63-1.07, P < 0.001), creatine kinase-MB (SMD = 0.48 U/L, 95% CI = 0.32-0.65, P < 0.001), and myoglobin (SMD = 0.55 U/L, 95% CI = 0.45-0.65, P < 0.001) exhibited a prominent level of mortality from COVID-19 infection. CONCLUSION: Cardiac biomarkers (cardiac troponin I, cardiac troponin T, high-sensitive cardiac troponin, high-sensitive cardiac troponin I, high-sensitive cardiac troponin T, creatine kinase-MB, and myoglobin) should be more frequently applied in identifying high-risk COVID-19 patients so that timely treatment can be implemented to reduce severity and mortality in COVID-19 patients.
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An et al. (2021) conducted a meta-analysis in COVID-19 (n=9,532). Elevated cardiac biomarkers vs. Lower levels of cardiac biomarkers was evaluated on COVID-19 severity (SMD 0.81, 95% CI 0.14-1.48, p=0.017). Elevated cardiac biomarkers, such as cardiac troponin I, were significantly associated with increased COVID-19 severity (SMD 0.81; 95% CI 0.14-1.48; P=0.017) and mortality.
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