Prognostic Accuracy of Cardiovascular Disease Biomarkers in Patients with COVID-19: A Diagnostic Test Accuracy Meta‐analysis
Abstract
Background: Several reports have determined that cardiovascular diseases (CVDs) are common complications in patients with coronavirus disease 2019 (COVID-19) and lead them to poor outcomes. CVD biomarkers have, thus, great potential to be used as prognostic biomarkers. We aimed to determine the accuracy of CVD biomarkers for the prognosis of the COVID-19 patient’s outcome via a diagnostic test accuracy (DTA) meta-analysis.
Methods: Until September 30, 2020, we searched Web of Sciences, Scopus, and MEDLINE/PubMed databases to obtain related papers. The summary points and lines were calculated using bivariate/HSROC model. As outcomes, we considered critical conditions and mortality.
Results: A total of 17 659 patients from 33 studies were included. Five biomarkers, namely increased levels of lactate dehydrogenase (LDH), cardiac troponin I (cTnI), creatine kinase (CK), D-dimer, and thrombocytopenia, met the inclusion criteria. Our results indicated that LDH and cTnI had good accuracy for the prognosis of critical condition (AUCHSROC=0.83 and 0.80, respectively), while LDH, cTnI, and D-dimer had acceptable accuracy (AUCHSROC=0.74, 0.71, and 0.72, respectively) for the prognosis of mortality. LDH and D-dimer had high sensitivity, whereas cTnI had high specificity. The other biomarkers did not have acceptable accuracy. Significant publication bias was found for D-dimer (P=0.053).
Conclusion: Among CVD biomarkers, LDH and cTnI had good accuracy for the prognosis of critical outcomes and acceptable accuracy for the prognosis of mortality, without publication bias. Given their different sensitivities and specificities, we recommend the use of these 2 biomarkers concomitantly.
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24. Han H, Xie L, Liu R, Yang J, Liu F, Wu K, Chen L, Hou W, Feng Y, Zhu C. Analysis of heart injury laboratory parameters in 273 COVID-19 patients in one hospital in Wuhan, China. J Med Virol 2020;92:819-823.
25. Li Y, Hu Y, Yu J, Ma T. Retrospective analysis of laboratory testing in 54 patients with severe- or critical-type 2019 novel coronavirus pneumonia. Lab Invest 2020;100:794-800.
26. Hu R, Han C, Pei S, Yin M, Chen X. Procalcitonin levels in COVID-19 patients. Int J Antimicrob Agents 2020;56:106051.
27. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Shi J, Zhou M, Wu B, Yang Z, Zhang C, Yue J, Zhang Z, Renz H, Liu X, Xie J, Xie M, Zhao J. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;146:110-118.
28. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, Shang Y. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost 2020;18:1469-1472.
29. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C, Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091.
30. Cao J, Tu WJ, Cheng W, Yu L, Liu YK, Hu X, Liu Q. Clinical features and short-term outcomes of 102 patients with Coronavirus disease 2019 in Wuhan, China. Clin Infect Dis 2020;71:748-755.
31. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, Siau E. Risk factors for mortality in patients with COVID-19 in New York city. J Gen Intern Med 2020:1–10.
32. Perez-Guzman PN, Daunt A, Mukherjee S, Crook P, Forlano R, Kont MD, Løchen A, Vollmer M, Middleton P, Judge R, Harlow C, Soubieres A, Cooke G, White PJ, Hallett TB, Aylin P, Ferguson N, Hauck K, Thursz MR, Nayagam S. Clinical characteristics and predictors of outcomes of hospitalized patients with COVID-19 in a multi-ethnic London NHS Trust: a retrospective cohort study. Clin Infect Dis 2020:ciaa1091.
33. Pan F, Yang L, Li Y, Liang B, Li L, Ye T, Li L, Liu D, Gui S, Hu Y, Zheng C. Factors associated with death outcome in patients with severe coronavirus disease-19 (COVID-19): a case-control study. Int J Med Sci 2020;17:1281-1292.
34. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.2020;395(10229):1054-1062.
35. Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, Lu H, Liu J, Yang J, Dong Y, Pan D, Shu C, Li J, Wei J, Huang Y, Peng L, Wu M, Zhang R, Wu B, Li Y, Cai L, Li G, Zhang T, Wu G. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. Lancet Oncol 2020;21:904-913.
36. Berenguer J, Ryan P, Rodríguez-Baño J, Jarrín I, Carratalà J, Pachón J, Yllescas M, Arribas JR. haracteristics and predictors of death among 4,035 consecutively hospitalized patients with COVID-19 in Spain. Clin Microbiol Infect 2020;26:1525–1536.
37. Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, Guo GY, Du J, Zheng CL, Zhu Q, Hu M, Li XY, Peng P, Shi HZ. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J 2020;55:2000524.
38. Si D, Du B, Ni L, Yang B, Sun H, Jiang N, Liu G, Massé S, Jin L, Nanthakumar J, Bhaskaran A, Yang P, Nanthakumar K. Death, discharge and arrhythmias among patients with COVID-19 and cardiac injury. CMAJ 2020;192:E791-E798.
39. Shang Y, Liu T, Wei Y, Li J, Shao L, Liu M, Zhang Y, Zhao Z, Xu H, Peng Z, Zhou F, Wang X. Scoring systems for predicting mortality for severe patients with COVID-19. EClinicalMedicine 2020;24:100426.
40. Xu J, Yang X, Yang L, Zou X, Wang Y, Wu Y, Zhou T, Yuan Y, Qi H, Fu S, Liu H, Xia J, Xu Z, Yu Y, Li R, Ouyang Y, Wang R, Ren L, Hu Y, Xu D, Zhao X, Yuan S, Zhang D, Shang Y. Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China. Crit Care 2020;24:394.
41. Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, Long D, Yu L. Association between platelet parameters and mortality in coronavirus disease 2019: retrospective cohort study. Platelets 2020;31:490-496.
42. Zhang J, Wang X, Jia X, Li J, Hu K, Chen G, Wei J, Gong Z, Zhou C, Yu H, Yu M, Lei H, Cheng F, Zhang B, Xu Y, Wang G, Dong W. Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China. Clin Microbiol Infect 2020;26:767-772.
43. Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, Xie J, Guan W, Liang W, Ni Z, Hu Y, Liu L, Shan H, Lei C, Peng Y, Wei L, Liu Y, Hu Y, Peng P, Wang J, Liu J, Chen Z, Li G, Zheng Z, Qiu S, Luo J, Ye C, Zhu S, Zheng J, Zhang N, Li Y, He J, Li J, Li S, Zhong N; Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol 2020;146:89-100.
44. Liao D, Zhou F, Luo L, Xu M, Wang H, Xia J, Gao Y, Cai L, Wang Z, Yin P, Wang Y, Tang L, Deng J, Mei H, Hu Y. Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study. Lancet Haematol 2020;7:e671-e678.
45. Long H, Nie L, Xiang X, Li H, Zhang X, Fu X, Ren H, Liu W, Wang Q, Wu Q. D-dimer and prothrombin time are the significant indicators of severe COVID-19 and poor prognosis. Biomed Res Int 2020;2020:6159720.
46. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, Chen X, Chen S, Yu K, Huang Z, Hu B. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study. J Intensive Care 2020;8:49.
47. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A, Müller MA, Drosten C, Pöhlmann S. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271-280.e8.
48. Guo J, Huang Z, Lin L, Lv J. Coronavirus disease 2019 (COVID-19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome coronavirus 2 infection. J Am Heart Assoc 2020;9:e016219.
49. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J Virol 2020;94:e00127- e00120.
50. Cohen J. The immunopathogenesis of sepsis. Nature 2002;420:885-891.
51. Zare ME, Wang Y, Nasir Kansestani A, Almasi A, Zhang J. Procalcitonin has good accuracy for prognosis of critical condition and mortality in COVID-19: a diagnostic test accuracy systematic review and meta-analysis. Iran J Allergy Asthma Immunol 2020;19:557-569.
2. Soraya GV, Ulhaq ZS. Crucial laboratory parameters in COVID-19 diagnosis and prognosis: an updated meta-analysis. Med Clin (Barc) 2020;155:143-151.
3. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clin Chem Lab Med 2020;58:1063-1069.
4. Zou F, Qian Z, Wang Y, Zhao Y, Bai J. Cardiac injury and COVID-19: a systematic review and meta-analysis. CJC Open 2020;2:386-394.
5. Aboughdir M, Kirwin T, Abdul Khader A, Wang B. Prognostic value of cardiovascular biomarkers in COVID-19: a review. Viruses 2020;12:527.
6. Kim KW, Lee J, Choi SH, Huh J, Park SH. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-Part I. General guidance and tips. Korean J Radiol 2015;16:1175-1187.
7. Lee J, Kim KW, Choi SH, Huh J, Park SH. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-Part II. Statistical methods of meta-analysis. Korean J Radiol 2015;16:1188-1196.
8. Zhao JY, Yan JY, Qu JM. Interpretations of "Diagnosis and treatment protocol for novel coronavirus pneumonia (Trial Version 7)". Chin Med J (Engl) 2020;133:1347-1349.
9. Mathes T, Pieper D. An algorithm for the classification of study designs to assess diagnostic, prognostic and predictive test accuracy in systematic reviews. Syst Rev 2019;8:226.
10. Sabbagh HJ, Hassan MH, Innes NP, Elkodary HM, Little J, Mossey PA. Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis. PLoS One 2015;10:e0116963.
11. Safari S, Baratloo A, Elfil M, Negida A. Evidence based emergency medicine; part 5 receiver operating curve and area under the curve. Emerg (Tehran) 2016;4:111-113.
12. Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol 2010;5:1315-1316.
13. Freeman SC, Kerby CR, Patel A, Cooper NJ, Quinn T, Sutton AJ. Development of an interactive web-based tool to conduct and interrogate meta-analysis of diagnostic test accuracy studies: MetaDTA. BMC Med Res Methodol 2019;19:81.
14. Wang F, Hou H, Luo Y, Tang G, Wu S, Huang M, Liu W, Zhu Y, Lin Q, Mao L, Fang M, Zhang H, Sun Z. The laboratory tests and host immunity of COVID-19 patients with different severity of illness. JCI Insight 2020;5:e137799.
15. Li H, Xiang X, Ren H, Xu L, Zhao L, Chen X, Long H, Wang Q, Wu Q. Serum amyloid a is a biomarker of severe coronavirus disease and poor prognosis. J Infect 2020;80:646-655.
16. Chan SSW, Christopher D, Tan GB, Chong VCL, Fan BE, Lin CY, Ong KH. Peripheral lymphocyte subset alterations in COVID-19 patients. Int J Lab Hematol 2020;42:e199-e203.
17. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, Mucheli SS, Kuperan P, Ong KH. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020;95:E131-E134.
18. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506.
19. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, Wang Z, Li J, Li J, Feng C, Zhang Z, Wang L, Peng L, Chen L, Qin Y, Zhao D, Tan S, Yin L, Xu J, Zhou C, Jiang C, Liu L. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci 2020;63:364-374.
20. Chen C, Chen C, Yan JT, Zhou N, Zhao JP, Wang DW. [Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19]. Zhonghua Xin Xue Guan Bing Za Zhi 2020;48:567-571.
21. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, Satlin MJ, Campion TR, Jr, Nahid M, Ringel JB, Hoffman KL, Alshak MN, Li HA, Wehmeyer GT, Rajan M, Reshetnyak E, Hupert N, Horn EM, Martinez FJ, Gulick RM, Safford MM. Clinical characteristics of Covid-19 in New York city. N Engl J Med 2020;382:2372-2374.
22. Feng Y, Ling Y, Bai T, Xie Y, Huang J, Li J, Xiong W, Yang D, Chen R, Lu F, Lu Y, Liu X, Chen Y, Li X, Li Y, Summah HD, Lin H, Yan J, Zhou M, Lu H, Qu J. COVID-19 with different severities: a multicenter study of clinical features. Am J Respir Crit Care Med 2020;201:1380-1388.
23. Zhou B, She J, Wang Y, Ma X. The clinical characteristics of myocardial injury in severe and very severe patients with 2019 novel coronavirus disease. J Infect 2020;81:147-178.
24. Han H, Xie L, Liu R, Yang J, Liu F, Wu K, Chen L, Hou W, Feng Y, Zhu C. Analysis of heart injury laboratory parameters in 273 COVID-19 patients in one hospital in Wuhan, China. J Med Virol 2020;92:819-823.
25. Li Y, Hu Y, Yu J, Ma T. Retrospective analysis of laboratory testing in 54 patients with severe- or critical-type 2019 novel coronavirus pneumonia. Lab Invest 2020;100:794-800.
26. Hu R, Han C, Pei S, Yin M, Chen X. Procalcitonin levels in COVID-19 patients. Int J Antimicrob Agents 2020;56:106051.
27. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Shi J, Zhou M, Wu B, Yang Z, Zhang C, Yue J, Zhang Z, Renz H, Liu X, Xie J, Xie M, Zhao J. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;146:110-118.
28. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, Shang Y. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost 2020;18:1469-1472.
29. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C, Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091.
30. Cao J, Tu WJ, Cheng W, Yu L, Liu YK, Hu X, Liu Q. Clinical features and short-term outcomes of 102 patients with Coronavirus disease 2019 in Wuhan, China. Clin Infect Dis 2020;71:748-755.
31. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, Siau E. Risk factors for mortality in patients with COVID-19 in New York city. J Gen Intern Med 2020:1–10.
32. Perez-Guzman PN, Daunt A, Mukherjee S, Crook P, Forlano R, Kont MD, Løchen A, Vollmer M, Middleton P, Judge R, Harlow C, Soubieres A, Cooke G, White PJ, Hallett TB, Aylin P, Ferguson N, Hauck K, Thursz MR, Nayagam S. Clinical characteristics and predictors of outcomes of hospitalized patients with COVID-19 in a multi-ethnic London NHS Trust: a retrospective cohort study. Clin Infect Dis 2020:ciaa1091.
33. Pan F, Yang L, Li Y, Liang B, Li L, Ye T, Li L, Liu D, Gui S, Hu Y, Zheng C. Factors associated with death outcome in patients with severe coronavirus disease-19 (COVID-19): a case-control study. Int J Med Sci 2020;17:1281-1292.
34. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.2020;395(10229):1054-1062.
35. Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, Lu H, Liu J, Yang J, Dong Y, Pan D, Shu C, Li J, Wei J, Huang Y, Peng L, Wu M, Zhang R, Wu B, Li Y, Cai L, Li G, Zhang T, Wu G. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. Lancet Oncol 2020;21:904-913.
36. Berenguer J, Ryan P, Rodríguez-Baño J, Jarrín I, Carratalà J, Pachón J, Yllescas M, Arribas JR. haracteristics and predictors of death among 4,035 consecutively hospitalized patients with COVID-19 in Spain. Clin Microbiol Infect 2020;26:1525–1536.
37. Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, Guo GY, Du J, Zheng CL, Zhu Q, Hu M, Li XY, Peng P, Shi HZ. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J 2020;55:2000524.
38. Si D, Du B, Ni L, Yang B, Sun H, Jiang N, Liu G, Massé S, Jin L, Nanthakumar J, Bhaskaran A, Yang P, Nanthakumar K. Death, discharge and arrhythmias among patients with COVID-19 and cardiac injury. CMAJ 2020;192:E791-E798.
39. Shang Y, Liu T, Wei Y, Li J, Shao L, Liu M, Zhang Y, Zhao Z, Xu H, Peng Z, Zhou F, Wang X. Scoring systems for predicting mortality for severe patients with COVID-19. EClinicalMedicine 2020;24:100426.
40. Xu J, Yang X, Yang L, Zou X, Wang Y, Wu Y, Zhou T, Yuan Y, Qi H, Fu S, Liu H, Xia J, Xu Z, Yu Y, Li R, Ouyang Y, Wang R, Ren L, Hu Y, Xu D, Zhao X, Yuan S, Zhang D, Shang Y. Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China. Crit Care 2020;24:394.
41. Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, Long D, Yu L. Association between platelet parameters and mortality in coronavirus disease 2019: retrospective cohort study. Platelets 2020;31:490-496.
42. Zhang J, Wang X, Jia X, Li J, Hu K, Chen G, Wei J, Gong Z, Zhou C, Yu H, Yu M, Lei H, Cheng F, Zhang B, Xu Y, Wang G, Dong W. Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China. Clin Microbiol Infect 2020;26:767-772.
43. Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, Xie J, Guan W, Liang W, Ni Z, Hu Y, Liu L, Shan H, Lei C, Peng Y, Wei L, Liu Y, Hu Y, Peng P, Wang J, Liu J, Chen Z, Li G, Zheng Z, Qiu S, Luo J, Ye C, Zhu S, Zheng J, Zhang N, Li Y, He J, Li J, Li S, Zhong N; Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol 2020;146:89-100.
44. Liao D, Zhou F, Luo L, Xu M, Wang H, Xia J, Gao Y, Cai L, Wang Z, Yin P, Wang Y, Tang L, Deng J, Mei H, Hu Y. Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study. Lancet Haematol 2020;7:e671-e678.
45. Long H, Nie L, Xiang X, Li H, Zhang X, Fu X, Ren H, Liu W, Wang Q, Wu Q. D-dimer and prothrombin time are the significant indicators of severe COVID-19 and poor prognosis. Biomed Res Int 2020;2020:6159720.
46. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, Chen X, Chen S, Yu K, Huang Z, Hu B. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study. J Intensive Care 2020;8:49.
47. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A, Müller MA, Drosten C, Pöhlmann S. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271-280.e8.
48. Guo J, Huang Z, Lin L, Lv J. Coronavirus disease 2019 (COVID-19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome coronavirus 2 infection. J Am Heart Assoc 2020;9:e016219.
49. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J Virol 2020;94:e00127- e00120.
50. Cohen J. The immunopathogenesis of sepsis. Nature 2002;420:885-891.
51. Zare ME, Wang Y, Nasir Kansestani A, Almasi A, Zhang J. Procalcitonin has good accuracy for prognosis of critical condition and mortality in COVID-19: a diagnostic test accuracy systematic review and meta-analysis. Iran J Allergy Asthma Immunol 2020;19:557-569.
| Files | ||
| Issue | Vol 16 No 1 (2021): J Teh Univ Heart Ctr | |
| Section | Meta‐Analysis | |
| DOI | https://doi.org/10.18502/jthc.v16i1.6594 | |
| Keywords | ||
| COVID-19; Biomarkers; Lactate dehydrogenase; Troponin I; Prognosis | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Nasir Kansestani A, Zare ME, Zhang J. Prognostic Accuracy of Cardiovascular Disease Biomarkers in Patients with COVID-19: A Diagnostic Test Accuracy Meta‐analysis. J Tehran Heart Cent. 2021;16(1):1-14.
