Cardiac injury markers of poor prognosis in COVID-19: meta-analysis

  • Li X & al.
  • Crit Care
  • 28 Jul 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Markers of cardiac injury are prognostic for poor outcomes in COVID-19.
  • High troponin I (TnI) is linked to a more than 5-fold increased risk for sever disease, ICU admission, and mortality in hospitalized patients with COVID-19, according to this meta-analysis.

Why this matters

  • Because cardiac injury is now recognized as common with COVID-19, identifying related markers can be crucial for understanding which patients are at greatest risk.
  • The authors say that these findings provide “some evidence for treatment guidelines.”

Key results

  • Meta-analysis of 23 studies with 4631 patients.
  • 16 studies had >100 patients.
  • With elevated vs nonelevated TnI, relative risk (95% CIs) was increased for:
    • Severe disease: 5.57 (3.04-10.22).
    • ICU admission: 6.20 (2.52-15.29).
    • Death: 5.64 (2.69-11.83).
    • Heterogeneity among studies was fairly high.
  • Elevated creatine kinase also was linked to increased risk for severe disease or ICU admission.
  • New-onset arrhythmia also was an ominous sign, predicting severe disease and ICU admission.
  • Elevated IL-6 was linked to increased risk for severe disease, ICU admission, and death.

Study design

  • Meta-analysis of retrospective studies.
  • Funding: National Key R&D Program of China.

Limitations

  • With attention to cardiac injury increasing only recently, some biomarker values may be underrepresented.