Serum CK-MB, COVID-19 severity and mortality: An updated systematic review and meta-analysis with meta-regression

Zinellu, Angelo; Sotgia, Salvatore; Fois, Alessandro Giuseppe; Mangoni, Arduino A.

doi:10.1016/j.advms.2021.07.001

Cited by 32 publications

(20 citation statements)

References 90 publications

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“…The serum troponin I was significantly increased only in severe cases. These results are in concordance with those of previous publications [ 39 , 40 , 41 , 42 ], which recommended that patients check cardiac markers at admission, which helps medical staff predict the severity of patients in the later stage, and these cardiac biomarkers in serum could act as prognostic biomarkers in COVID-19 patients. As stated by Li et al [ 40 ] and Sultan et al [ 43 ], the mechanisms of actions of COVID-19 to induce heart injury include specific binding to functional receptors on cardiomyocytes and immune-mediated myocardial injury.…”

Section: Discussionsupporting

confidence: 92%

Correlations between Kidney and Heart Function Bioindicators and the Expressions of Toll-Like, ACE2, and NRP-1 Receptors in COVID-19

et al. 2022

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Background: COVID-19 impacts the cardiovascular system resulting in myocardial damage, and also affects the kidneys leading to renal dysfunction. This effect is mostly through the binding with angiotensin-converting enzyme 2 (ACE2) and Neuropilin-1 (NRP-l) receptors. Toll-Like Receptors (TLRs) typically combine with microbial pathogens and provoke an inflammatory response. Aim: This work aims to compare the changes in kidney and heart function bioindicators and expressions of TLRs (TLR2 and TLR2) as well as ACE2 and NRP-l receptors in moderate and severe COVID-19 patients. The correlations between kidney and heart function bioindicators and expressions of these receptors are also studied. Patients and Methods: In this study, 50 healthy control and 100 COVID-19 patients (55 males and 45 females) were enrolled. According to WHO guidelines, these participants were divided into severe (50 cases) and moderate (50 cases). Serum creatinine, blood urea, CK-MB, LDH, and Troponin I were estimated. We measured the gene expression for Toll-Like Receptors (TLR2 and TLR4), ACE2, and NRP-1 in the blood samples using quantitative real-time PCR (qRT-PCR). Results: In comparison with the healthy group, all patients exhibited a significant elevation in serum creatinine, urea, cardiac enzymes (CK-MB and LDH), and CRP. Serum Troponin I level was significantly increased in severe COVID-19 patients. Furthermore, all studied patients revealed a significant elevation in the expression levels of TLR2, TLR4, ACE2, and NRP-1 mRNA. In all patients, CK-MB, ACE2, and NRP-1 mRNA expression levels were positively correlated with both TLR2 and TLR4 expression levels. Moreover, serum creatinine and urea levels were positively correlated with both TLR2 and TLR 4 expression levels in the severe group only. In the moderate group, serum CK-MB activity and Troponin I level had a significant positive correlation with both NRP-1 and ACE2 expression levels, while serum urea level and LDH activity had a significant positive correlation with NRP-1 only. In severe patients, the increases in serum creatinine, urea, CK-MB, and LDH were significantly associated with the elevations in both ACE2 and NRP-1 expression levels, whereas serum Troponin I level had a positive direct relationship with NRP-1 only. Conclusions: Our study concluded that expression levels for TLR2, TLR4, ACE2, and NRP-1 mRNA in both severe and moderate patients were positively correlated with renal biomarkers and cardiac enzymes. Innate immune markers can be important because they correlate with the severity of illness in COVID-19.

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Section: Discussionsupporting

confidence: 92%

Correlations between Kidney and Heart Function Bioindicators and the Expressions of Toll-Like, ACE2, and NRP-1 Receptors in COVID-19

et al. 2022

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“…Li et al found that elevated level of cardiac markers showed increased higher mortality than those normal serum levels [ 5 ]. Angelo Zinellu et al found that higher CK-MB concentrations were associated with the mortality and severe disease in COVID-19 patients [ 30 ]. But we found that CK-MB ( P = 0.363) and CK ( P = 0.489) had no significant difference in the prediction effect of the mortality.…”

Section: Discussionmentioning

confidence: 99%

Abnormal myocardial enzymes in the prediction of mortality and hypertension in COVID-19 patients: a retrospective study

Sha

Liu

Sun

et al. 2022

Aging

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This study aims to determine the differences in myocardial enzymes in COVID-19 patients with and without hypertension. A total of 130 patients with COVID-19 in Yunmeng County People's Hospital were analyzed. The clinical manifestations and laboratory indicators were collected and analyzed. We found that COVID-19 patients with hypertension had higher mortality rate, greater age, and higher rates of basic disease such as diabetes than patients without hypertension. The γ-glutamyl transpeptidase (GGT), blood urea nitrogen (BUN), albumin/globulin (A/G), Ca, Mg, lactate dehydrogenase (LDH), and ɑ-hydroxybutyric-dehydrogenase (ɑ-HBD) levels in COVID-19 patients with hypertension were higher than in COVID-19 patients without hypertension. We found that the predictive effect of the creatine kinase isoenzyme (CK-MB), LDH-L, and ɑ-HBD levels in the COVID-19 patients without hypertension were higher than in COVID-19 patients with hypertension. We used the ROC curve model to predict whether patients would have hypertension, and we found that CK-MB, LDH-L and HBD parameters could distinguish the COVID-19 patients with hypertension and non-hypertension, and could predict the mortality of COVID-19 patients.

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“…The majority of studies (46 studies) reported the impact of CI on mortality (Table 1) [5,12,15,17,18,20,[22][23][24]29,[31][32][33]35,39,40,[42][43][44][45][46][47][48][49][50][51][52][53][56][57][58][59][60][61][62][63][64][65][66][67]70,73,74,[76][77][78].…”

Section: Resultsmentioning

confidence: 99%

Cardiac Injury in COVID-19: A Systematic Review of Relevant Meta-Analyses

Kyriakoulis¹,

Kyriakoulis²,

Trontzas³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Cardiac injury (CI) is not a rare condition among hospitalized patients with coronavirus disease 2019 . Its prognostic value has been extensively reported through the literature, mainly in the context of observational studies. An impressive number of relevant meta-analyses has been conducted. These meta-analyses present similar and consistent results; yet interesting methodological issues emerge. Methods: A systematic literature search was conducted aiming to identify all relevant meta-analyses on (i) the incidence, and (ii) the prognostic value of CI among hospitalized patients with COVID-19. Results: Among 118 articles initially retrieved, 73 fulfilled the inclusion criteria and were included in the systematic review. Various criteria were used for CI definition mainly based on elevated cardiac biomarkers levels. The most frequently used biomarker was troponin. 30 meta-analyses reported the pooled incidence of CI in hospitalized patients with COVID-19 that varies from 5% to 37%. 32 meta-analyses reported on the association of CI with COVID-19 infection severity, with only 6 of them failing to show a statistically significant association. Finally, 46 meta-analyses investigated the association of CI with mortality and showed that patients with COVID-19 with CI had increased risk for worse prognosis. Four meta-analyses reported pooled adjusted hazard ratios for death in patients with COVID-19 and CI vs those without CI ranging from 1.5 to 3. Conclusions: The impact of CI on the prognosis of hospitalized patients with COVID-19 has gained great interest during the pandemic. Methodological issues such as the inclusion of not peer-reviewed studies, the inclusion of potentially overlapping populations or the inclusion of studies with unadjusted analyses for confounders should be taken into consideration. Despite these limitations, the adverse prognosis of patients with COVID-19 and CI has been consistently demonstrated.

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Serum CK-MB, COVID-19 severity and mortality: An updated systematic review and meta-analysis with meta-regression

Cited by 32 publications

References 90 publications

Correlations between Kidney and Heart Function Bioindicators and the Expressions of Toll-Like, ACE2, and NRP-1 Receptors in COVID-19

Correlations between Kidney and Heart Function Bioindicators and the Expressions of Toll-Like, ACE2, and NRP-1 Receptors in COVID-19

Abnormal myocardial enzymes in the prediction of mortality and hypertension in COVID-19 patients: a retrospective study

Cardiac Injury in COVID-19: A Systematic Review of Relevant Meta-Analyses

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