Table 1.
Characterization of Cardiac Biomarkers by Primary Origin, Release Mode, Normal Range and Mortality Prediction in COVID-19.
| Biomarkers | Primary Origin | Primary Release Mode | Molecular Weight (kD) | Normal Range | Mortality in COVID-19 |
|---|---|---|---|---|---|
| Biomarkers of Myocyte Injury | |||||
| Hs-cTn | Cardiac myocytes | Myocardial injury | 24 (Trop I) 35 (Trop T) |
Assay specific cut-offs | I |
| CK-MB | Cardiac myocytes, skeletal muscle |
Muscle injury (primarily heart) |
84 | 5–25 IU/L [20] | I |
| Myoglobin | Cardiac myocytes, skeletal muscle |
Muscle injury | 17.7 | Mean 31 ng/mL (+/− 1.3) [21] | I |
| Pentraxin-3 | Smooth muscle cells, vascular endothelial cells, macrophages | Vascular injury/inflammation | 40.2 | M: 1.87 ng/mL (CI, 1.81–1.94) [22] F: 2.12 ng/mL (CI, 2.05–2.19) [22] |
I |
| Biomarkers of Myocardial Stretch | |||||
| NT-proBNP | Ventricular myocytes | Ventricular volume or pressure overload | 8.5 | M: 42.5–106.4 pg/mL (97.5 percentile) [23] F: 111.0–215.9 pg/mL (97.5 percentile) [23] |
I |
| MR-proANP | Atrial myocytes | Atrial volume or pressure overload | 2.6 (ANP) |
M: 90.2–228 pmol/mL (97.5 percentile) [24] F: 118–214 pmol/mL (97.5 percentile) [24] |
III |
| Biomarkers of Extracellular Matrix Remodeling | |||||
| sST2 | Cardiac and lung cells | Inflammation/fibrosis/vascular congestion | 37 | M: mean 24.9 ng/mL (95% CI, 23.7–26.2) [25] F: mean 16.9 ng/mL (95% CI, 16.1–17.7) [25] |
II |
| Galectin-3 | Mostly non-cardiac: macrophages/ fibroblasts |
Fibrosis | 30 | Median 62 ng/mL (IQR, 20–313) [26] | II |
| GDF-15 | Unknown | Inflammation | 16.7 | 2.5 percentile: 399 ng/L (90% CI, 399–399) [27] 97.5 percentile: 1335 ng/L (90% CI, 1152–1445) [27] |
I |
| Biomarkers of Neurohumoral Activation | |||||
| Copeptin | Pituitary gland | Osmotic stimulation/stress | 4021 | Median 4.2 pmol/L (IQR, 1.0–13.8) [28] | II |
| MR-proADM | Ubiquitary | Neurohumoral activation/inflammation | 5.1 | 2.5 percentile: 0.21 nmol/L (90% CI, 0.19–0.23) [29] 97.5 percentile: 0.57 nmol/L (90% CI, 0.55–0.59) [29] |
I |
| Endothelin-1 | Vascular endothelial cells | Pleiotropic (pulsatile stretch, hypoxemia…) | 2492 | M: 2.64 ng/L (IQR, 2.21–3.17) [30] F: 2.46 ng/L (IQR, 2.05–2.94) [30] |
III |
I—more than 3 studies with mortality prediction in COVID-19; II—2 or 3 studies with mortality prediction in COVID-19; III—less than 2 studies with mortality prediction in COVID-19; kD—kilodaltons; CI—confidence interval; IQR—interquartile range; Hs-cTn—high-sensitive cardiac troponin; CK-MB—creatine kinase–myoglobin binding; NT-ptoBNP—N-terminal pro-B-type natriuretic peptide; MR-proANP—Mid-regional pro atrial natriuretic peptide; sST-2—soluble ST2; GDF-15—growth differentiation factor 15; MR-proADM—mid-regional adrenomedullin.