Plasma brain natriuretic peptide, D-Dimer, and serum troponin-I as predictors for in-hospital death in patients with COVID-19

The Egyptian Journal of Immunology
Volume 30 (3), July, 2023
Pages: 32 – 43.
www.Ejimmunology.org
https://doi.org/10.55133/eji.300304
Amal A. Mahmoud1, Heba A. Abd El-Hafeez1, Areej O. Ali1, Ayman K. M. Hassan2, and Mohamed I. Seddik1
1Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.

2Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt.

 

Corresponding author:
Areej O. Ali, Department of Clinical Pathology, Faculty of Medicine, Assiut University., Assiut, Egypt.
Email: areejosama@aun.edu.eg.

 

Abstract

The severe acute respiratory syndrome coronavirus 2, first appeared in Wuhan, China, in December 2019. Since then, a variety of strains of the virus were spread throughout the world, prompting the World Health Organization to declare a pandemic in March 2020. Additionally, Coronavirus disease 2019 (COVID-19) can cause a variety of symptoms, ranging from fatigue and fever to severe respiratory and cardiovascular complications. This study evaluated the role of brain natriuretic peptide (BNP), troponin-I and D-dimer as biomarkers for death prediction in hospitalized patients with COVID-19. The study included 90 patients with COVID -19 diagnosed with PCR-RNA testing. They were divided into survivors and non-survivors. Also, 20 apparently healthy individuals age and sex matched were included as a control group. Plasma BNP and serum troponin-I were measured by enzyme linked immune-sorbent assay (ELISA) technique. D-dimer was measured by a turbidimetric technique. Patients with COVID-19 had significantly elevated levels of serum Troponin-I and plasma BNP in comparison to controls (p< 0.0001, for both). D-dimer, troponin–I and BNP levels were significantly higher in the non-survivors group when compared to the survivors group. Troponin-1 can predict COVID-19 severity with sensitivity, specificity, and accuracy of 55.1%, 66.7%, and 57.8%, respectively at a cutoff value of 0.075 (ng /ml); and area under the receiver operating characteristic (AUC) curve of 0.670 (95% CI: 0.551 – 0.790, p=0.018). BNP can predict COVID-19 severity with sensitivity, specificity, and accuracy of 98.6%, 71.4%, 92.2%, respectively at a cutoff value of 16.02 (Pg /ml) and AUC of 0.872 (95% CI: 0.778 – 0.965, p<0.001). Univariate and multivariate logistic regression analysis showed that only BNP level can significantly predict death among COVID-19 infected patients. In conclusion, plasma BNP and serum troponin-I could be used as prognostic biomarkers for determination of the severity of COVID-19 and BNP could predict mortality.

Keywords:
COVID-19, BNP, Troponin-I, D-dimer

Date received:
20 January 2022; accepted: 19 April 2023

PMID:
37439528

 

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