Key result
Elevated NT-proBNP predicts ICU admission with ~90% specificity in COVID-19, whereas CoQ10 shows no difference.
Why the study?
The utility of testing CoQ10 and NT-proBNP levels alongside conventional transthoracic echocardiography to detect early cardiac abnormalities in severe COVID-19 infections required investigation.
Do plasma CoQ10 and NT-proBNP levels along with conventional transthoracic echocardiography detect early subtle cardiac abnormalities and predict ICU admission in COVID-19 patients?
Case-Control (n=90)
Do plasma CoQ10 and NT-proBNP levels along with conventional transthoracic echocardiography detect early subtle cardiac abnormalities and predict ICU admission in COVID-19 patients?
NT-proBNP testing and transthoracic echocardiography can serve as screening tools to detect subtle cardiac abnormalities and predict ICU admission in severe COVID-19 patients, whereas measuring plasma CoQ10 is not recommended.
Answers are grounded in this paper and cite their sources.
NT-proBNP and echocardiography may predict ICU admission in COVID-19; leaves open prospective validation before clinical adoption.
Background: COVID-19 outbreak led to a series of acute atypical respiratory diseases. The host immune response to the corona virus “SARS-CoV-2” is considered a key determinant of disease pathogenesis and the resulting clinical outcomes. Coenzyme Q10 (CoQ10) is known for its role as a potent antioxidant in affected organs specially the cardiovascular system. We sought to investigate the early occurrence of cardiac abnormalities that may arise in severe COVID-19 infections by testing blood levels of CoQ10, N-terminal pro-brain natriuretic peptide (NT-proBNP) and performing conventional transthoracic echocardiography. Subjects and methods: Subjects were categorized into three groups. Group “1”: 30 COVID-19 cases requiring intensive care unit (ICU) admission, group “2”: 30 mild COVID-19 home-isolated cases and group “3”: 30 healthy age and sex matched controls. All subjects were tested for CoQ10 and NT-proBNP blood levels as well as conventional transthoracic echocardiography.Results: There was statistical significance between the three study groups regarding ejection fraction (EF), tricuspid annular plane systolic excursion (TAPSE) and NT-proBNP (p-value: <0.001, 0.001 and <0.001 respectively). CoQ10 level was not significantly different between the three study groups (p-value: 0.496). A cut-off of 960.9 μg/L NT-proBNP is desired to predict the likeliness of ICU admission in COVID-19 patients with sensitivity 73% and specificity 90%. There was a weak negative correlation between CoQ10 and interleukin-6 (r-value: -0.391 and p-value: 0.032). Conclusion: Subtle cardiac abnormalities that may happen as a result of severe COVID-19 infection can be detected by measuring blood levels of NT-proBNP and performing an echocardiography as a screening tool to all ICU-admitted COVID-19 patients. However, it is not recommended to measure plasma levels of CoQ10 in COVID-19 patients.
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Sandra Karas (2026) conducted a case-control in COVID-19 (n=90). Severe/mild COVID-19 evaluated by blood CoQ10, NT-proBNP, and transthoracic echocardiography vs. Healthy age and sex matched controls (and mild COVID-19 cases) was evaluated on Ejection fraction (EF), tricuspid annular plane systolic excursion (TAPSE), NT-proBNP, and CoQ10 levels across groups (p=<0.001). NT-proBNP, EF, and TAPSE differed across groups, unlike CoQ10.
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