The Value of Cardiac Biomarkers in Predicting in-Hospital Death in COVID-19 Patients

Abstract

Given the strong evidence of direct invasion of coronavirus to myocardial tissue, as well as increasing the patient's susceptibility to inflammatory and thrombotic phenomena, it has been hypothesized that elevated levels of cardiac enzymes can predict disease severity and its poor prognosis. We aimed to determine the value of cardiac prognostic biomarkers along with other laboratory parameters in predicting in-hospital mortality of COVID-19 patients. This prospective study was performed on 30 consecutive patients with the definitive diagnosis of severe COVID-19. On admission, along with recording demographic characteristics, intravenous blood samples were extracted from the patients after at least 8 hours of fasting to evaluate other laboratory parameters. Comparing laboratory parameters across the survived and non-survived groups showed significantly higher mean CK-MB level in non-survived group than alive group (70.90±29.79 versus 43.56±22.02, P=0.020). Also, positive troponin I was reported in 38.1% of non-survived group, while in none of the patients in survived group (P=0.031). Using the logistic regression model, raised CK-MB could effectively predict in-hospital death among COVID-19 patients (OR=1.047, P=0.043). Area under the ROC curve analysis showed high value of raised CK-MB for predicting in-hospital death among COVID-19 patients. Raised CK-MB level on admission can predict in-hospital death in patients with severe COVID-19.