Myoglobin and C-reactive protein are efficient and reliable early predictors of COVID-19 associated mortality

• Published in: Scientific reports Vol. 11; no. 1; p. 5975
• Main Authors: Ali, Ashaq, Noman, Muhammad, Guo, Yong, Liu, Xu, Zhang, Rong, Zhou, Juan, Zheng, Yang, Zhang, Xian-En, Qi, Yong, Chen, Xiaohua, Men, Dong
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 16.03.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/1807; 692/308; 692/499; 692/53; 692/700; Aged; Aged, 80 and over; Biomarkers; Biomarkers - blood; Blood; C-reactive protein; C-Reactive Protein - analysis; Calcium-binding protein; Comorbidity; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - mortality; COVID-19 - pathology; COVID-19 - virology; Female; Humanities and Social Sciences; Humans; Liver; Male; Middle Aged; Mortality; multidisciplinary; Multiple Organ Failure - etiology; Myoglobin - analysis; Myoglobins; Renal function; Retrospective Studies; Risk Factors; SARS-CoV-2 - isolation & purification; Science; Science (multidisciplinary); Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Survival Analysis; Thorax - diagnostic imaging; Tomography, X-Ray Computed; Troponin; Troponin I - blood
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-85426-9

Since the emergence of SARS-CoV-2, numerous studies have been attempting to determine biomarkers, which could rapidly and efficiently predict COVID-19 severity, however there is lack of consensus on a specific one. This retrospective cohort study is a comprehensive analysis of the initial symptoms, comorbidities and laboratory evaluation of patients, diagnosed with COVID-19 in Huoshenshan Hospital, Wuhan, from 4th February to 12th March, 2020. Based on the data collected from 63 severely ill patients from the onset of symptoms till the full recovery or demise, we found not only age (average 70) but also blood indicators as significant risk factors associated with multiple organ failure. The blood indices of all patients showed hepatic, renal, cardiac and hematopoietic dysfunction with imbalanced coagulatory biomarkers. We noticed that the levels of LDH (85%, P < .001), HBDH (76%, P < .001) and CRP (65%, P < .001) were significantly elevated in deceased patients, indicating hepatic impairment. Similarly, increased CK (15%, P = .002), Cre (37%, P = 0.102) and CysC (74%, P = 0.384) indicated renal damage. Cardiac injury was obvious from the significantly elevated level of Myoglobin (52%, P < .01), Troponin-I (65%, P = 0.273) and BNP (50%, P = .787). SARS-CoV-2 disturbs the hemolymphatic system as WBC# (73%, P = .002) and NEUT# (78%, P < .001) were significantly elevated in deceased patients. Likewise, the level of D-dimer (80%, P < .171), PT (87%, P = .031) and TT (57%, P = .053) was elevated, indicating coagulatory imbalances. We identified myoglobin and CRP as specific risk factors related to mortality and highly correlated to organ failure in COVID-19 disease.