Biomarcadores de Lesão Miocárdica e Complicações Cardíacas Associadas à Mortalidade em Pacientes com COVID-19

Abstract

Background: SARS-CoV-2 is an emerging RNA virus associated with a severe acute respiratory disease known as COVID-19. Although COVID-19 is predominantly a pulmonary disease, some patients have severe cardiovascular damage. We performed a quantitative evidence synthesis of clinical data, myocardial injury biomarkers, and cardiac complications associated with in-hospital death in patients with COVID-19. Methods: We searched the databases PubMed, Embase, and Google Scholar to identify studies comparing clinical data, myocardial injury biomarkers, and cardiac complications between non-survivors and survivors of COVID-19. Effect sizes were reported as mean difference or standardized mean difference for continuous variables and risk ratio for dichotomous variables with 95% confidence intervals. A random effects model was used to pool the results. Results: Six retrospective studies reporting data from 1,141 patients (832 survivors and 309 non-survivors) were included. We found that underlying cardiovascular conditions; elevation of high-sensitivity cardiac troponin I, N-terminal pro-Btype natriuretic peptide, and creatine kinase-MB; and cardiac complications were associated with increased risk of death for patients with SARS-CoV-2 infection. Conclusions: The confirmation that underlying cardiovascular conditions, elevation of myocardial injury biomarkers during COVID-19 infection, and acute cardiovascular decompensation are predictors for mortality in SARS-CoV-2 infection must encourage new research to clarify potential mechanisms and test appropriate treatments. (Arq Bras Cardiol. 2020; 115(2):273-277

The Role of Biomarkers in Hospitalized COVID-19 Patients With Systemic Manifestations

“…Furthermore, the study revealed that concomitant treatment with corticosteroids may have resulted in a better response with anakinra treatment. 71 These findings illustrate the value of using medications based on biomarkers such as the anti-cytokine tocilizumab and anakinra to improve outcomes for patients with COVID-19. Clinicians can measure the levels of cytokines such as IL-6 to identify the early stages of the cytokine storm and administer anti-cytokine medications to improve patient outcomes.…”

“…Cytokine inhibitors have decreased mortality in patients with severe COVID-19, highlighting their role in preventing COVID-19 deaths. 71 An observational study was conducted to confirm the optimal timing of IL-6 receptor inhibitor (IL-6ri) administration for 255 COVID-19 patients. During the IL-6ri administration, patients were divided into 2 groups; the stage IIB group required less than 45% of inspired oxygen (FiO 2 ), and the stage III group required more than 45% of FiO 2 .…”

Estilo de Vida, Saúde Física e Mental de Idosos no Contexto da Covid-19

“…Considerando a alta taxa de morbimortalidade da COVID-19, os idosos, a partir de 60 anos, foram considerados o maior grupo de risco. A fragilidade do sistema imunológico e aumento de comorbidades nessa população, os tornam mais susceptíveis às formas graves, em caso de contato com a doença (Martins et al, 2020). Autores afirmam que durante o período pandêmico elevou-se o número da população sedentária, devido às recomendações para que a população aderisse à s medidas de isolamento domiciliar.…”

Predictive Value of Myocardial injury in Patients with COVID-19 Admitted to a Quaternary Hospital in the City of Rio de Janeiro

“…There is growing evidence of an association between myocardial injury and an increased risk of death in patients with COVID-19. Several studies involving patients with confirmed COVID-19 have implied the elevation of serum hTnI not only with mortality, 4,[12][13][14][15][16][17][18][19] but also criticality. 8,14,16 Although some investigators 4,14,16,18 have found an association between inflammatory biomarkers with poor prognosis, in the present study, only higher levels of hTnI were independently associated with mortality (table 3).…”