Evidence map›Paper›PMID 32530509›Full record

SynthesisJournal of medical virology2020

Association of cardiac biomarkers and comorbidities with increased mortality, severity, and cardiac injury in COVID-19 patients: A meta-regression and decision tree analysis.

Eman A Toraih, Rami M Elshazli, Mohammad H Hussein, Abdelaziz Elgaml, Mohamed Amin, Mohammed El-Mowafy, Mohamed El-Mesery, Assem Ellythy, Juan Duchesne, Mary T Killackey and 3 more

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of medical virology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 8 pooled it
2.5field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 8 syntheses or guidelines pooled it, 108 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 3 countries.

Eman A ToraihDepartment of Surgery, School of Medicine, Tulane University, New Orleans, LA.ORCID 0000-0001-9267-3787
Rami M ElshazliDepartment of Biochemistry and Molecular Genetics, Faculty of Physical Therapy, Horus University - Egypt, New Damietta, Egypt.ORCID 0000-0002-3381-2641
Mohammad H HusseinDepartment of Surgery, School of Medicine, Tulane University, New Orleans, LA.ORCID 0000-0001-8278-7094
Abdelaziz ElgamlDepartment of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.ORCID 0000-0001-6790-5849
Mohamed AminDepartment of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.ORCID 0000-0002-8167-2356
Mohammed El-MowafyDepartment of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.ORCID 0000-0002-4375-5724
Mohamed El-MeseryDepartment of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.ORCID 0000-0003-2649-3002
Assem EllythyDepartment of Surgery, School of Medicine, Tulane University, New Orleans, LA.
Juan DuchesneDepartment of Surgery, Trauma/Acute Care and Critical Care, Tulane School of Medicine, New Orleans, LA.ORCID 0000-0002-1490-1585
Mary T KillackeyDepartment of Surgery, School of Medicine, Tulane University, New Orleans, LA.ORCID 0000-0003-3546-6946
Keith C FerdinandJohn W. Deming Department of Medicine, School of Medicine, Tulane University, New Orleans, LA.ORCID 0000-0003-3338-4410
Emad KandilDivision of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, 70112, USA.ORCID 0000-0001-5895-4403
Manal S FawzyDepartment of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.ORCID 0000-0003-1252-8403
Tulane University · USMansoura University · EGDamietta University · EGSuez Canal University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronavirus disease-2019 (COVID-19) has a deleterious effect on several systems, including the cardiovascular system. We aim to systematically explore the association of COVID-19 severity and mortality rate with the history of cardiovascular diseases and/or other comorbidities and cardiac injury laboratory markers.

methodsThe standardized mean difference (SMD) or odds ratio (OR) and 95% confidence intervals (CIs) were applied to estimate pooled results from the 56 studies. The prognostic performance of cardiac markers for predicting adverse outcomes and to select the best cutoff threshold was estimated by receiver operating characteristic curve analysis. Decision tree analysis by combining cardiac markers with demographic and clinical features was applied to predict mortality and severity in patients with COVID-19.

resultsA meta-analysis of 17 794 patients showed patients with high cardiac troponin I (OR = 5.22, 95% CI = 3.73-7.31, P < .001) and aspartate aminotransferase (AST) levels (OR = 3.64, 95% CI = 2.84-4.66, P < .001) were more likely to develop adverse outcomes. High troponin I more than 13.75 ng/L combined with either advanced age more than 60 years or elevated AST level more than 27.72 U/L was the best model to predict poor outcomes.

conclusionsCOVID-19 severity and mortality are complicated by myocardial injury. Assessment of cardiac injury biomarkers may improve the identification of those patients at the highest risk and potentially lead to improved therapeutic approaches.

Indexed as

BiomarkersCardiovascular DiseasesComorbidityCOVID-19Decision TreesHeart InjuriesHumansMyocardiumPrognosisRegression AnalysisSeverity of Illness IndexBiomarkerscardiac injurycardiac markersCOVID-19meta-analysisoutcomeSARS-CoV-2

Identifiers

PMID32530509
PMCPMC7307124
OpenAlexW3035161663

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.