Abstract
BackgroundMyocardial damage worsens the clinical course and prognosis of coronavirus disease 2019 (COVID-19) patients. High total bilirubin levels have been associated with a poor prognosis in COVID-19. This study aimed to investigate the predictive value of the total bilirubin level, a marker of heme oxygenase-1 enzyme activity, in determining myocarditis in patients with COVID-19.ResultsA total of 190 patients diagnosed with COVID-19 were enrolled in the study. The patients were divided into two groups based on their troponin positivity. The study group (n = 95) consisted of patients with high troponin, and the control group (n = 95) consisted of patients without high troponin levels. The D-dimer (727 [572–995] vs. 591 [440–790], p = 0.001), C-reactive protein (CRP) (30.0 [10–48] vs. 10.3 [5.8–15.9], p < 0.001), and total bilirubin (9.5 [8.2–12.1] vs. 7.0 [5.3–8.0], p < 0.001) levels were significantly higher in the study group. In multivariate analysis, CRP (odds ratio [OR]: 1.103; 95% confidence interval [CI]: 1.060–1.148; p < 0.001) and total bilirubin (OR: 1.612; 95% CI: 1.330–1.954; p < 0.001) levels were independent predictors of myocarditis in COVID-19.ConclusionsTotal bilirubin levels can be used as an early predictor of myocarditis in COVID-19 and can contribute to therapy management.
Highlights
Myocardial damage worsens the clinical course and prognosis of coronavirus disease 2019 (COVID19) patients
Complete blood counts and glucose, creatinine, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), and creatine kinase myocardial band (CK-MB) levels in the blood samples taken at the admission did not differ significantly between the groups
The results of our study showed that the total bilirubin levels, which are an indicator of Heme oxygenase (HO)-1 enzyme activity, and the C-reactive protein (CRP) levels were independent predictors of myocarditis in COVID-19 patients
Summary
Myocardial damage worsens the clinical course and prognosis of coronavirus disease 2019 (COVID19) patients. Human coronavirus (CoV) infections were considered to cause mild respiratory disease in the twentieth century [1]. The third pandemic, called coronavirus disease 2019 (COVID-19) and caused by the severe acute respiratory syndrome (SARS)-CoV-2, started in late 2019 and continues at the time of this writing, with transmission rates higher than those of both previous CoV outbreaks [5, 6]. One study showed that more than half of the patients who died had an acute myocardial injury and that the extrapulmonary organ most commonly affected by COVID-19 was the heart [12]
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