Abstract
Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2, has caused widespread morbidity and mortality worldwide. Cardiac injury is reported to be common in hospitalized patients. We evaluated whether Pro B-type Natriuretic Peptide (proBNP) levels measured on admission in COVID-19 patients were associated with worse outcomes. A retrospective analysis of laboratory-confirmed COVID-19 patients who were admitted between February 2020 and July 2020 to Al Kuwait Hospital, Dubai, UAE. Patients were divided into two groups: normal proBNP (≤125 ng/L) and high proBNP (>125 ng/L) upon admission. Clinical characteristics and outcomes were compared between the two groups. A total of 389 patients were studied. Overall, mean age was 50.2 years (range 16-94 years), 77.3% were males, 35.7% diabetics, 35.2% hypertensives and 5.6% had history of cardiovascular disease. Compared to the group with normal proBNP; patients with high proBNP on admission were: older, more diabetics and hypertensives, with more history of cardiovascular disease; they presented with abnormal chest radiograph; and had lower lymphocytes, higher neutrophils, lower eGFR, higher D-dimers, higher CRP and higher procalcitonin on admission laboratory tests. These patients had more risk of developing critical illness during the hospitalization, undergoing mechanical ventilation and risk of death. Elevated pro B-type natriuretic peptide levels on admission in COVID-19 patients may predict subsequent risk of developing critical illness, undergoing mechanical ventilation, and significant high risk of death.
Highlights
Since first reported in Wuhan, China, in December 2019 [1], COVID-19 disease, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), has caused widespread morbidity and mortality
Elevated cardiac troponin levels in COVID-19 has been reported to be associated with adverse outcomes including mortality [4], few have reported about the significance of pro B-type natriuretic peptide in these patients
We included all patients who had a positive Real Time Reverse Transcription Polymerase Chain Reaction test to diagnose COVID-19 and pro B-type natriuretic peptide (proBNP) level measured on admission
Summary
Since first reported in Wuhan, China, in December 2019 [1], COVID-19 disease, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), has caused widespread morbidity and mortality. Huang et al [2] reported a 12% incidence of acute cardiac injury in patients with COVID-19, while another study of 138 hospitalized Covid-19 patients reported that 7.2% had acute myocardial injury and 16.7% had arrhythmias [3]. Elevated cardiac troponin levels in COVID-19 has been reported to be associated with adverse outcomes including mortality [4], few have reported about the significance of pro B-type natriuretic peptide (proBNP) in these patients. We conducted this study to evaluate whether high proBNP levels upon admission are associated with adverse events during hospitalization
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