Background: Patients with cardiovascular diseases are susceptible to poor outcomes in COVID-19 infection. Knowing their prognosis will help to allocate resources to provide them with the best care. This article reviews the best available literature about laboratory markers that can be done on admission of COVID-19 patients with cardiovascular problems and help to predict their prognosis. Design and Methods: Search engines such as Google Scholar, Pubmed and Google were used to collect data on published studies using combination of search words “COVID-19” and one or more of the following: mortality, Leucopenia, thrombocytopenia, Ferritin, CRP, troponin, IL-6, LDH and coagulopathy. Results: There is robust evidence that laboratory markers can predict the prognosis in COVID-19 infected patients, including those with cardiovascular problems. Poor outcomes were correlated with the following: Lymphopenia, thrombocytopenia and high LDH, hs-cTn, D-dimer, PT, FDP, Ferritin, CRP, PCT and IL-6. Elevated PCT is related to secondary bacterial infection in severe cases. IL-6 inhibitor (Tocilizumab) can be a good treatment option for severe and critical COVID-19 cases and should be further studied by randomized control trials. Conclusion: Certain laboratory markers should be requested on admission of COVID-19 patients with cardiovascular problems to improve their management and outcomes.
Cite this paper
Elkammash, A. , Degheidy, N. , Kanaan, S. , Farag, F. , Ahmed, M. and Khalifa, A. (2020). COVID-19 Patients with Cardiovascular Diseases: Important Laboratory Markers to Predict Prognosis. Open Access Library Journal, 7, e6652. doi: http://dx.doi.org/10.4236/oalib.1106652.
Zhou, F., Yu, T., Du, R., et al. (2020) Clinical Course and Risk Factors for Mortality of Adult Inpatients with COVID-19 in Wuhan, China: A Retrospective Cohort Study. The Lancet, 395, 1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
Wang, Y., Wang, Y., Chen, Y. and Qin, Q.S. (2020) Unique Epidemiological and Clinical Features of the Emerging 2019 Novel Coronavirus Pneumonia (COVID-19) Implicate Special Control Measures. Journal of Medical Virology, 92, 568-576.
https://doi.org/10.1002/jmv.25748
Xu, H., Zhong, L., Deng, J., et al. (2020) High Expression of ACE2 Receptor of 2019-nCoV on the Epithelial Cells of Oral Mucosa. International Journal of Oral Science, 12, Article No. 8. https://doi.org/10.1038/s41368-020-0074-x
Liao, Y.-C., Liang, W.-G., Chen, F.-W., Hsu, J.-H., Yang, J.J. and Chang, M.S. (2002) IL-19 Induces Production of IL-6 and TNF-α and Results in Cell Apoptosis through TNF-α. The Journal of Immunology, 169, 4288-4297.
https://doi.org/10.4049/jimmunol.169.8.4288
Fischer, K., Hoffmann, P., Voelkl, S., et al. (2007) Inhibitory Effect of Tumor Cell-Derived Lactic Acid on Human T Cells. Blood, 109, 3812-3819.
https://doi.org/10.1182/blood-2006-07-035972
Lippi, G., Lavie, C.J. and Sanchis-Gomar, F. (2020) Cardiac Troponin I in Patients with Coronavirus Disease 2019 (COVID-19): Evidence from a Meta-Analysis. Progress in Cardiovascular Diseases, 63, 390-391.
https://doi.org/10.1016/j.pcad.2020.03.001
Januzzi Jr., J.L. (2020) Troponin and BNP Use in COVID-19. American College of Cardiology.
https://www.acc.org/latest-in-cardiology/articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19
Han, Y., Zhang, H., Mu, S., et al. (2020) Lactate Dehydrogenase, a Risk Factor of Severe COVID-19 Patients. MedRxiv.
https://doi.org/10.1101/2020.03.24.20040162
Zhou, B., She, J.Q., Wang, Y.D. and Ma, X.C. (2019) Utility of Ferritin, Procalcitonin, and C-Reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease. Current Status: Posted, 1-13. https://doi.org/10.21203/rs.3.rs-18079/v1
Lippi, G. and Plebani, M. (2020) Procalcitonin in Patients with Severe Coronavirus Disease 2019 (COVID-19): A Meta-Analysis. Clinica Chimica Acta, 505, 190-191.
https://doi.org/10.1016/j.cca.2020.03.004
Coomes, E.A. and Haghbayan, H. (2020) Interleukin-6 in COVID-19: A Systematic Review and Meta-Analysis. MedRxiv. https://doi.org/10.1101/2020.03.30.20048058
Klok, F.A., Kruip, M.J.H.A., Van Der Meer, N.J.M., et al. (2020) Incidence of Thrombotic Complications in Critically Ill ICU Patients with COVID-19. Thrombosis Research, 191, 145-147. https://doi.org/10.1016/j.thromres.2020.04.013
Giannis, D., Ziogas, I.A. and Gianni, P. (2020) Coagulation Disorders in Coronavirus Infected Patients: COVID-19, SARS-CoV-1, MERS-CoV and Lessons from the Past. Journal of Clinical Virology, 127, Article ID: 104362.
https://doi.org/10.1016/j.jcv.2020.104362
Tang, N., Li, D., Wang, X., et al. (2020) Abnormal Coagulation Parameters Are Associated with Poor Prognosis in Patients with Novel Coronavirus Pneumonia. Journal of Thrombosis and Haemostasis, 18, 844-847. https://doi.org/10.1111/jth.14768
Lippi, G., Plebani, M. and Henry, B.M. (2020) Thrombocytopenia Is Associated with Severe Coronavirus Disease 2019 (COVID-19) Infections: A Meta-Analysis. Clinica Chimica Acta, 506, 145-148. https://doi.org/10.1016/j.cca.2020.03.022
