Myoglobin and C-reactive protein are efficient and reliable early predictors of COVID-19 associated mortality

Abstract

Since the emergence of SARS-CoV-2, numerous studies have been attempting to determine biomarkers, which could rapidly and efficiently predict COVID-19 severity, however there is lack of consensus on a specific one. This retrospective cohort study is a comprehensive analysis of the initial symptoms, comorbidities and laboratory evaluation of patients, diagnosed with COVID-19 in Huoshenshan Hospital, Wuhan, from 4th February to 12th March, 2020. Based on the data collected from 63 severely ill patients from the onset of symptoms till the full recovery or demise, we found not only age (average 70) but also blood indicators as significant risk factors associated with multiple organ failure. The blood indices of all patients showed hepatic, renal, cardiac and hematopoietic dysfunction with imbalanced coagulatory biomarkers. We noticed that the levels of LDH (85%, P < .001), HBDH (76%, P < .001) and CRP (65%, P < .001) were significantly elevated in deceased patients, indicating hepatic impairment. Similarly, increased CK (15%, P = .002), Cre (37%, P = 0.102) and CysC (74%, P = 0.384) indicated renal damage. Cardiac injury was obvious from the significantly elevated level of Myoglobin (52%, P < .01), Troponin-I (65%, P = 0.273) and BNP (50%, P = .787). SARS-CoV-2 disturbs the hemolymphatic system as WBC# (73%, P = .002) and NEUT# (78%, P < .001) were significantly elevated in deceased patients. Likewise, the level of D-dimer (80%, P < .171), PT (87%, P = .031) and TT (57%, P = .053) was elevated, indicating coagulatory imbalances. We identified myoglobin and CRP as specific risk factors related to mortality and highly correlated to organ failure in COVID-19 disease.

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

“…Similarly, we found that a decreased lymphocyte ratio and an increased neutrophil ratio, and C-reactive protein levels correlated with disease mortality. Again, these findings are consistent with the literature, which linked these parameters to COVID-19 severity and mortality [37][38][39]. The reproducibility of these biomarker findings across several studies conducted in varying patient populations suggests that they could play a useful role in identifying an early time point for those patients with a worse prognosis who may require closer monitoring in a critical care setting.…”

Vertical Transmission Potential of SARS-CoV-2 From Infected Mother to Twin Neonates

“…In the current study, laboratory tests confirmed infection in the patient; however, lymphocytes, leukocytes, ALT and AST were found to be within the normal range. An increase in C-reactive protein was observed, which might be an adverse clinical manifestation [ 10 , 11 ]. Although the pregnant woman was diagnosed with PROM, no risk factors, including pre-eclampsia, history of cesarean section or fetal distress, were observed.…”

Possible Role of Pets, Wild and Domestic Animals in the Transmission of Covid-19 to Humans

“…Reservoir host animals of CoV, including rodents and bats, carry similar receptors as present in intermediate hosts including bovines, camels and masked palm civet (Salata et al 2020;Wang et al 2020;Ye et al 2020). The presence of these receptors (ACE2 or DPP4) in humans makes them susceptible to MERS-CoV and SARS-CoV, causing MERS and SARS infections, respectively (Song et al 2005;Tiwari et al 2020;Ali et al 2021). The spike present on the MERS-CoV has the capability to become accustomed to the disparity in the receptors DPP4 of the host species (Letko et al 2018).…”

“…Though it is stated that pathogenesis of COVID-19 is not clear, however, in most of the cases, it primarily affects the lungs. Ali et al (2021) have stated in this regards that the key mechanism for SARS-CoV-2 invasion is the binding of the virus to the ACE2 membrane-bound receptor and the host cell's internalization of the complex (Zhang et al 2020). ACE2, a glycoprotein and metalloprotease, is present both in membrane-bound, as well as in soluble, forms (Jia et al 2009).…”

“…The serological results also help us in selecting the convalescent plasma used to treat COVID-19 infection (FDA 2020). According to Ali et al (2021), myoglobin and C-reactive protein (CRP) are specific risk factors related to mortality and highly correlated to organ failure in COVID-19 disease. Real-time RT-PCR is the widely used technique and is gold standard for the etiologic identification of SARS-CoV-2 in animals (Richard et al 2020;Zhong et al 2020).…”