单位：[1]Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun, China吉林大学中日联谊医院[2]Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China[3]Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China器官移植研究所华中科技大学同济医学院附属同济医院器官移植[4]Department of Ultrasound, China-Japan Hospital of Jilin University, Changchun, China吉林大学中日联谊医院[5]The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, University Health Network, Toronto, Canada[6]Peter Munk Cardiac Centre, University Health Network, Toronto, Canada[7]The Ted Rogers Centre for Heart Research, Toronto, Canada
Background: We previously described the mortality associated with cardiac injury in patients with coronavirus disease 2019 (COVID-19). The activation of immune and thrombotic biomarkers at admission, and their ability to predict cardiac injury and mortality patterns in COVID-19, remains unclear. Methods: This retrospective cohort study included 170 patients with COVID-19 with cardiac injury at the time of admission to Tongji Hospital in Wuhan between January 29, 2020, and March 8, 2020. The temporal evolution of inflammatory cytokines, coagulation markers, clinical treatment, and mortality were analyzed. Continuous variables are expressed as median (interquartile range). The Mann -Whitney test was used for two -group comparisons, whereas the Kruskal-Wallis test was used for comparisons among three groups. Categorical variables are expressed as proportions and percentages, and Fisher's exact test was used to compare differences. A multivariate regression model was used to predict in -hospital death. A simple linear regression analysis was applied to examine the correlation between baseline biomarkers and peak cTnI levels. Results: Of the 170 patients, 60 (35.3%) died early (<21 d), and 61 (35.9%) died after a prolonged stay. The admission laboratory findings correlating with early death were elevated interleukin 6 (IL -6) (P < 0.0001), tumor necrosis factor-alpha (P = 0.0025), and C -reactive protein (P < 0.0001). We observed the trajectory of biomarker changes in patients after admission hospitalization, and determined that early mortality was associated with a rapidly increasing D-dimer level, and gradually decreasing platelet and lymphocyte counts. Multivariate and simple linear regression models indicated that the risk of death was associated with immune and thrombotic pathway activation. Elevated admission cTnI levels were associated with elevated IL -6 (P = 0.03) and D-dimer (P = 0.0021) levels. Conclusion: In patients with COVID-19 with cardiac injury, IL -6 and D-dimer levels at admission predicted subsequently elevated cTnI levels and early death, thus highlighting the need for early inflammatory cytokine-based risk stratification in patients with cardiac injury.
基金：
National Natural Science Foundation of China [82100337]; General Project of Natural Science Foundation of Jilin Province [YDZJ202201ZYTS097]; Bethune Program of Jilin University [419161900105]
第一作者单位：[1]Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun, China
通讯作者：
通讯机构：[1]Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun, China[5]The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, University Health Network, Toronto, Canada[*1]Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China[*2]The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, University Health Network, Toronto, Canada
推荐引用方式(GB/T 7714)：
Kexin Peng,Beibei Du,Daoyuan Si,et al.IL-6 and D-dimer Levels at Admission Predict Cardiac Injury and Early Mortality during SARS-CoV-2 Infection[J].CARDIOVASCULAR INNOVATIONS AND APPLICATIONS.2024,9(1):doi:10.15212/CVIA.2024.0009.
APA：
Kexin Peng,Beibei Du,Daoyuan Si,Lina Jin,Bo Yang...&Ping Yang.(2024).IL-6 and D-dimer Levels at Admission Predict Cardiac Injury and Early Mortality during SARS-CoV-2 Infection.CARDIOVASCULAR INNOVATIONS AND APPLICATIONS,9,(1)
MLA：
Kexin Peng,et al."IL-6 and D-dimer Levels at Admission Predict Cardiac Injury and Early Mortality during SARS-CoV-2 Infection".CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 9..1(2024)
