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Observational Study
. 2021 Mar;26(2):119-126.
doi: 10.1080/1354750X.2021.1874052. Epub 2021 Jan 18.

Biomarkers and short-term prognosis in COVID-19

Óscar M Peiró  1   2   3 , Anna Carrasquer  1   2   3 , Raúl Sánchez-Gimenez  1   2   3 , Nisha Lal-Trehan  1   2   3 , Víctor Del-Moral-Ronda  1   2   3 , Gil Bonet  1   2   3 , Isabel Fort-Gallifa  4 , Ester Picó-Plana  4 , Natalia Bastón-Paz  4 , Cristina Gutiérrez  4 , Alfredo Bardaji  1   2   3
Affiliations
Observational Study

Biomarkers and short-term prognosis in COVID-19

Óscar M Peiró et al. Biomarkers. 2021 Mar.

Abstract

Purpose: The aim of our study was to analyse the short-term prognostic value of different biomarkers in patients with COVID-19.

Methods: We included patients admitted to emergency department with COVID-19 and available concentrations of cardiac troponin I (cTnI), D-dimer, C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients were classified for each biomarker into two groups (low vs. high concentrations) according to their best cut-off point, and 30-day all-cause death was evaluated.

Results: After multivariate adjustment, cTnI ≥21 ng/L, D-dimer ≥1112 ng/mL, CRP ≥10 mg/dL and LDH ≥334 U/L at admission were associated with an increased risk of 30-day all-cause death (hazard ratio (HR) 4.30; 95% CI 1.74-10.58; p = 0.002; HR 3.35; 95% CI 1.58-7.13; p = 0.002; HR 2.25; 95% CI 1.13-4.50; p = 0.021; HR 2.00; 95% CI 1.04-3.84; p = 0.039, respectively). The area under the curve for cTnI was 0.825 (95% CI 0.759-0.892) and, in comparison, was significantly better than CRP (0.685; 95% CI 0.600-0.770; p = 0.009) and LDH (0.643; 95% CI 0.534-0.753; p = 0.006) but non-significantly better than D-dimer (0.756; 95% CI 0.674-0.837; p = 0.115).

Conclusions: In patients with COVID-19, increased concentrations of cTnI, D-dimer, CRP and LDH are associated with short-term mortality. Of these, cTnI provides better mortality risk prediction. However, differences with D-dimer were non-significant.

Keywords: Biomarkers; C-reactive protein; COVID-19; D-dimer; lactate dehydrogenase; short-term prognosis; troponin.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow diagram of patients.
Figure 2.
Figure 2.
All-cause death cumulative survival by cTnI, D-dimer, CRP and LDH.
Figure 3.
Figure 3.
ROC curves for predicting all-cause death.
See this image and copyright information in PMC

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