Evidence map›Paper›PMID 35691587›Full record

ArticleClinical biochemistry2022

Serial cardiac biomarkers for risk stratification of patients with COVID-19.

Kwaku Tawiah, Laurel Jackson, Catherine Omosule, Claire Ballman, Bobby Shahideh, Mitchell G Scott, Gillian Murtagh, Christopher W Farnsworth

Abstract read
In one paragraph

Article in Clinical biochemistry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

8 authors.

Kwaku TawiahDepartment of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States.
Laurel JacksonCore Diagnostics, Abbott Laboratories, Abbott Park, IL, United States.
Catherine OmosuleDepartment of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States.
Claire BallmanDepartment of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States.
Bobby ShahidehCore Diagnostics, Abbott Laboratories, Abbott Park, IL, United States.
Mitchell G ScottDepartment of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States.
Gillian MurtaghCore Diagnostics, Abbott Laboratories, Abbott Park, IL, United States.
Christopher W FarnsworthDepartment of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States. Electronic address: cwfarnsworth@wustl.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSeveral studies have demonstrated an association between elevated cardiac biomarkers and adverse outcomes in patients with COVID-19. However, the prognostic and predictive capability of a multimarker panel in a prospectively collected, diverse "all-comers" COVID-19 population has not been fully elucidated. DESIGN &

methodsWe prospectively assessed high sensitivity cardiac troponin I (hsTnI), NT-pro B-type Natriuretic Peptide (NT-proBNP), Galectin-3 (Gal-3), and procalcitonin (PCT) in 4,282 serial samples from 358 patients admitted with symptomatic, RT-PCR confirmed SARS-CoV-2 infection. Outcomes examined were 30-day in-hospital mortality and requirement for intubation within 10 days.

resultsBaseline hsTnI had the highest AUC for predicting 30-day mortality (0.81; 95% CI, 0.73-0.88), followed by NT-proBNP (0.80; 0.74-0.86), PCT (0.77; 0.70-0.84), and Gal-3 (0.68; 0.60-0.76). HsTnI < 3.5 ng/L at baseline identified patients at low risk for in-hospital mortality (NPV 95.9%, sensitivity 97.3%) and 10-day intubation (NPV 90.4%, sensitivity 88.5%). Continuous, log-2 increases in troponin concentration were associated with reduced survival (p < 0.001) on Kaplan-Meier curves and increased risk of 30-day mortality: HR 1.26 (1.16-1.37) in univariate and 1.19 (1.03-1.4) in multivariate models. Time-varying doubling of concentrations of hsTnI and Gal-3 were associated with increased risk of 30-day mortality (adjusted HR 1.21, 1.06-1.4, and 1.92, 1.40-2.6).

conclusionHsTnI, NT-proBNP, Gal-3, and PCT are elevated at baseline in patients that have worse outcomes from COVID-19. HsTnI was the only independent predictor of 30-day mortality and intubation. Time-varying, doubling in hsTnI and Gal-3 further aided in prognostication of adverse outcomes. These results support the use of hsTnI for triaging patients with COVID-19.

Indexed as

COVID-19BiomarkersHumansNatriuretic Peptide, BrainPeptide FragmentsProcalcitoninPrognosisRisk AssessmentSARS-CoV-2Troponin IBiomarkersNatriuretic Peptide, BrainPeptide FragmentsProcalcitoninTroponin IBiomarkersCOVID-19High sensitivity troponin

Identifiers

PMID35691587
PMCPMC9181199

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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.