Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2

doi:10.5501/wjv.v11.i5.375

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Sep 25, 2022 (publication date) through Mar 8, 2026

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World Journal of Virology

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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.

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

ARTICLE HIGHLIGHTS

Research background

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is prevalent worldwide. Though lung injury is the most common presentation, cardiovascular dysfunction is seen on account of the widespread inflammation.

Research motivation

Cardiac biomarkers are released secondary to cardiovascular injury, and can be used as surrogate markers to gauge the disease severity.

Research objectives

To identify the role of individual biomarkers in diagnosing cardiac injury, and implications in determining prognosis and mortality.

Research methods

An extensive literature search was conducted for all studies on patients with COVID-19 associated cardiovascular injury and cardiac bioenzymes. Articles were screened using PubMed/Medline database, additionally reference citation analysis tool was also used. Eligible articles were then included in the study.

Research results

Cardiac troponin was seen as a robust diagnostic marker of cardiovascular injury across studies. Elevated troponin levels correlated with the level of disease severity. Similar results were seen alongside elevations in natriuretic peptides, irrespective of their prior diagnosis of heart failure.

Research conclusions

Multiple cardiac biomarkers can help predict the severity of disease and serve for prognostication purposes. Assessment of bioenzymes at admission and their serial monitoring can help predict mortality in patients with COVID-19.

Research perspectives

New data is emerging on novel biomarkers including soluble ST2, galectin-3, presepsin and copeptin which can further aid in diagnostic evaluation alongside troponins and natriuretic peptides.