Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Sep 25, 2022; 11(5): 375-390
Published online Sep 25, 2022. doi: 10.5501/wjv.v11.i5.375
Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2
Anjani Muthyala, Sandeep Sasidharan, Kevin John John, Amos Lal, Ajay K Mishra
Anjani Muthyala, Sandeep Sasidharan, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Kevin John John, Department of Critical Care, Belivers Church Medical College Hospital, Thiruvalla 689103, Kerela, India
Amos Lal, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
Ajay K Mishra, Department of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: Mishra AK and Muthyala A contributed to the conceptual design of the study; Muthyala A and Sasidharan S independently screened the articles and extracted the data; Muthyala A, Sasidharan S, Mishra AK contributed to write-up and submission of the study; Mishra AK, John KJ and Lal A reviewed the final manuscript; all authors reviewed and agreed with the final content of the article.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ajay K Mishra, FACP, MBBS, MD, Academic Fellow, Assistant Professor, Department of Cardiology, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. ajay.mishra@stvincenthospital.com
Received: April 25, 2022
Peer-review started: April 25, 2022
First decision: May 31, 2022
Revised: June 12, 2022
Accepted: August 10, 2022
Article in press: August 10, 2022
Published online: September 25, 2022
Processing time: 152 Days and 9.3 Hours
Abstract
BACKGROUND

Cardiovascular complications have been increasingly recognized in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated coronavirus disease 2019 (COVID-19). Cardiac biomarkers are released because of this ongoing cardiovascular injury and can act as surrogate markers to assess the disease severity.

AIM

To review the variation and utility of these biomarkers in COVID-19 to ascertain their role in diagnosis, prognosis and clinical outcomes of the disease.

METHODS

We performed a literature search in PubMed, Medline and the Reference Citation Analysis (RCA), using the search terms “COVID-19” and “cardiac bioenzymes” or “cardiac biomarkers”. Additionally, we also used the latest reference citation analysis tool to identify more articles.

RESULTS

Cardiac troponin has been consistently elevated in patients with COVID-19 associated myocarditis, and strongly correlated with adverse prognosis. Natri-uretic peptides including brain natriuretic peptide (BNP) and pro-BNP is elevated in patients with COVID-19 associated cardiac injury, irrespective of their prior heart failure status, and independently correlated with worst outcomes. Alongside these traditional biomarkers, novel cardiac bioenzymes including presepsin, soluble ST2 and copeptin, are also increasingly recognized as markers of cardiovascular injury in COVID-19 and can be associated with poor outcomes.

CONCLUSION

Assessment of cardiac bioenzymes at admission and their serial monitoring can help assess the severity of disease and predict mortality in patients with SARS-CoV-2 infection. Future studies are needed to elude the critical importance of novel biomarkers.

Keywords: SARS-CoV-2; Troponin; Brain natriuretic peptide; Prognosis; Outcomes; Heart failure

Core Tip: Cardiac bioenzymes act as surrogate markers for various cardiovascular complications associated with coronavirus disease 2019 (COVID-19). Cardiac bioenzymes at admission and their serial monitoring can help assess the disease severity and predict mortality in patients with COVID-19. This review summarizes the role of these bioenzymes in diagnosis, prognosis and clinical implications on outcomes of various cardiovascular complications associated with COVID-19.