Prognostic value of NT-proBNP in patients with severe COVID-19

Lei Gao, Dan Jiang, Xue-Song Wen, Xiao-Cheng Cheng, Min Sun, Bin He, Lin-Na You, Peng Lei, Xiao-Wei Tan, Shu Qin, Guo-Qiang Cai, Dong-Ying Zhang, Lei Gao, Dan Jiang, Xue-Song Wen, Xiao-Cheng Cheng, Min Sun, Bin He, Lin-Na You, Peng Lei, Xiao-Wei Tan, Shu Qin, Guo-Qiang Cai, Dong-Ying Zhang

Abstract

Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China has been declared a public health emergency of international concern. The cardiac injury is a common condition among the hospitalized patients with COVID-19. However, whether N terminal pro B type natriuretic peptide (NT-proBNP) predicted outcome of severe COVID-19 patients was unknown.

Methods: The study initially enrolled 102 patients with severe COVID-19 from a continuous sample. After screening out the ineligible cases, 54 patients were analyzed in this study. The primary outcome was in-hospital death defined as the case fatality rate. Research information and following-up data were obtained from their medical records.

Results: The best cut-off value of NT-proBNP for predicting in-hospital death was 88.64 pg/mL with the sensitivity for 100% and the specificity for 66.67%. Patients with high NT-proBNP values (> 88.64 pg/mL) had a significantly increased risk of death during the days of following-up compared with those with low values (≤88.64 pg/mL). After adjustment for potential risk factors, NT-proBNP was independently correlated with in-hospital death.

Conclusion: NT-proBNP might be an independent risk factor for in-hospital death in patients with severe COVID-19.

Trial registration: ClinicalTrials, NCT04292964. Registered 03 March 2020.

Keywords: COVID-19; NT-proBNT; Outcome; SARS-CoV-2.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The NT-proBNP for in-hospital death of coronavirus disease 2019 (COVID-19) by receiver operating characteristic (ROC) curves. The area under the curve (AUC) of NT-proBNP was 0.909. The best cutoff of NT-proBNP for prediction in-hospital death was 88.64 pg/mL with the sensitivity of 100% and the specificity of 66.67%. 95% CI, 95% confidence interval
Fig. 2
Fig. 2
Kaplan-Meier plots showing the cumulative survival rate of COVID-19 patients who were stratified into two groups according to plasma NT-proBNP cutoff point at baseline. Dotted line, NT-proBNP ≤88.64 pg/ml, n = 24; Solid line, NT-proBNP > 88.64 pg/ml, n = 30; log-rank test for trend, P < 0.001)
Fig. 3
Fig. 3
Forest plots of multivariate Cox proportional-hazards regression analyzing the effect of baseline variables on in-hospital death. HP, hypertension; CHD, coronary heart disease; MYO, myoglobin; CK-MB, creatine kinase-MB; Hs-TnI, high-sensitivity troponin-I; WBC, white blood cell; LYM, lymphocytes; CRP, c-reactive protein; PCT, procalcitonin; HR, hazards ratio

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