Table 5.

Clinical value of cardiovascular and inflammatory biomarkers in patients with COVID-19

Cardiovascular biomarkers	Clinical relevance
Troponin	↑ in severe COVID-19 as compared to nonsevere COVID-19
	➢The median value of high-sensitivity troponin I was increased >2-fold in 36 patients who required ICU as compared to 102 patients who did not require ICU care52
	↑ in deceased patients compared to discharged patients
	➢The median value of high-sensitivity cardiac troponin I was increased >7-fold in 54 deceased patients with COVID-19 as compared to 137 discharged patients48
	➢The median value of high-sensitivity cardiac troponin I was increased >10-fold in 68 deceased patients with COVID-19 as compared to 82 discharged patients51
NT-proBNP	↑ in severe COVID-19 as compared to mild COVID-19
	➢The median value of NT-proBNP was increased >2-fold in 60 patients with severe COVID-19 as compared to 198 patients with mild COVID-1981
	↑ in deceased patients as compared to discharged patients
	➢The median value of NT-proBNP was increased >10-fold in 80 deceased patients with COVID-19 as compared to 93 recovered patients56
	➢Elevated NT-proBNP (≥285 pg/mL) were reported in 85% (68/80) of the deceased patients with COVID-19 as compared to 18% (17/93) of the recovered patients56
	➢An NT-proBNP increase of 100 pg/mL was associated with 1.37-fold risk of in-hospital death according to univariate Cox proportional hazards regression analysis of 54 patients with severe COVID-19174
D-Dimer	↑ in severe COVID-19 as compared to nonsevere COVID-19
	➢Elevated D-Dimers (>0.243 μg/mL) were reported in 61% (23/38) of the severe COVID-19 cases as compared to 28% (12/43) of the nonsevere COVID-19 cases167
	↑ in patients with ARDS as compared to patients without ARDS
	➢The median value of D-Dimer was increased >2-fold in 84 patients with COVID-19 who developed ARDS as compared to 117 patients who did not develop ARDS50
	↑ in deceased patients as compared to recovered patients
	➢The median value of D-Dimer was increased >8-fold in 54 deceased patients with COVID-19 as compared to 137 discharged patients48
Inflammatory biomarkers
CRP	↑ in severe COVID-19 as compared to nonsevere COVID-19
	➢The median value of CRP was increased 1.66-fold in 55 patients with severe COVID-19 as compared to 81 patients with nonsevere COVID-19167
	↑ in deceased patients as compared to discharged patients
	➢The median value of CRP was increased >3-fold in 68 deceased patients as compared to 82 discharged patients51
	➢CRP>100 mg/L was reported in 60% (59/98) of the deceased patients as compared to 14% (21/145) of the recovered patients56
IL-6	↑ in severe COVID-19 compared to nonsevere COVID-19
	➢The median value of IL-6 was increased ≈3-fold in 85 patients with refractory COVID-19 as compared to 70 patients with nonrefractory COVID-19175
	↑ in deceased patients as compared to discharged patients
	➢The median value of IL-6 was increased ≈2-fold in 68 deceased patients compared to 82 discharged patients51
Procalcitonin	↑ in severe COVID-19 as compared to nonsevere COVID-19
	➢The median value of procalcitonin was increased ≈2-fold in 50 patients with severe COVID-19 as compared to 68 patients with nonsevere COVID-19167
	↑ in patients who required ICU care as compared to no ICU care
	➢Procalcitonin ≥0.1 ng/mL was reported in 50% (6/12) of the patients who required ICU care as compared to 22% (6/27) of the patients who did not require ICU care34
Neutrophil-to-lymphocyte ratio (NLR)	•8% higher risk of in-hospital mortality for each unit increase in NLR, as estimated in an analysis of 245 patients with COVID-19176
	•Patients with NLR in the highest tertile had a >15-fold higher risk of death as compared to patients in the lowest tertile after adjustment for potential confounders176

ARDS: acute respiratory distress syndrome, COVID-19: coronavirus disease 2019, CRP: C-reactive protein, ICU: intensive care unit, IL-6: interleukin 6, NLR: neutrophil-to-lymphocyte ratio, and NT-proBNP: N-terminal (NT)- proB-type natriuretic peptide.