Elevated Natriuretic Peptides in Patients With Severe or Critical COVID-19: A Meta-Analysis

Benjamin Benhuri, Tadao Aikawa, Hisato Takagi, Daniel Benhuri, Toshiki Kuno

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The worldwide COVID-19 pandemic caused by SARS-CoV-2 has resulted in an extraordinary increase in the number of patients who are severely critically ill. For many of these patients, cardiovascular risk factors are key contributors to the development of severe illness. Laboratory markers for cardiac damage and failure, such as natriuretic peptides, are reported to be elevated in patients with severe COVID-19. Methods: We conducted a systematic review and meta-analysis to compare natri-uretic peptide levels in patients with severe COVID-19 vs those with nonsevere COVID-19. PubMed and medRxiv were searched through April 7, 2020. The outcome of interest was the difference in B-type natriuretic peptide (BNP) or N-terminal-proBNP levels in patients with severe vs nonsevere COVID-19. Results: We identified 9 retrospective cohort studies that had a total of 1,575 patients with COVID-19 who had their natriuretic peptides measured and were classified by disease severity. All studies were conducted in China. Patients with severe COVID-19 had significantly higher BNP levels than patients with nonsevere COVID-19 (mean difference, 69.56 pg/mL; 95% CI, 1.77-137.35 pg/mL; P = .04, I2 = 83%). Similarly, patients with severe COVID-19 had significantly higher N-terminal-proBNP levels than patients with nonsevere COVID-19 (mean difference, 518.65 pg/mL; 95% CI, 152.40-884.90 pg/mL; P = .006, I2 = 86%). Conclusions: In this study, Chinese patients with severe COVID-19 had higher natriuretic peptide levels than those with nonsevere COVID-19. Studies from all countries affected by the virus will help to further delineate whether the cause is directly or indirectly of cardiac origin and whether preexisting heart failure has an influence on this disparity.

Original languageEnglish
Article numbere207404
JournalTexas Heart Institute Journal
Volume49
Issue number5
DOIs
StatePublished - 2022
Externally publishedYes

Keywords

  • COVID-19
  • N-terminal proBNP
  • SARS-CoV-2
  • natriuretic peptide
  • severe illness

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