Meta-analysis of cardiac markers for predictive factors on severity and mortality of COVID-19

Abstract

Objectives: Previous observational studies have suggested that increased cardiac markers are commonly found in COVID-19. This study aimed to determine the relationship between several cardiac markers and the severity/mortality of COVID-19 patients. Methods: Several cardiac markers were analysed in this meta-analysis. RevMan 5.4 was used to provide pooled estimates for standardised mean difference (SMD) with 95% confidence intervals. Results: Twenty-nine clinical studies were included in this meta-analysis. Significantly higher CK-MB (0.64, 95% CI = 0.19–1.09), PCT (0.47, 95% CI = 0.26−0.68), NT-proBNP (1.90, 95% CI = 1.63–2.17), BNP (1.86, 95% CI = 1.63−2.09), and d-dimer (1.30, 95% CI = 0.91−1.69) were found in severe compared with non-severe COVID-19. Significantly higher CK-MB (3.84, 95% CI = 0.62−7.05), PCT (1.49, 95% CI = 0.86−2.13), NT-proBNP (4.66, 95% CI = 2.42−6.91), BNP (1.96, 95% CI = 0.78−3.14), troponin (1.64 (95% CI = 0.83−2.45), and d-dimer (2.72, 95% CI = 2.14−3.29) were found in those who died from compared with survivors of COVID-19. Conclusions: High CK-MB, PCT, NT-proBNP, BNP, and d-dimer could be predictive markers for severity of COVID-19, while high CK-MB, PCT, NT-proBNP, BNP, troponin, and d-dimer could be predictive markers for survival of COVID-19 patients.

Keywords

• COVID-19
• Cardiac marker
• Severity
• Mortality