loading page

Brain natriuretic peptide is an indicator for early risk-stratification and management for COVID-19 patients
  • +18
  • pengping li,
  • Wei Wu,
  • Tingting Zhang,
  • Ziyu Wang,
  • Ziyu Wang,
  • Mengyan Zhu,
  • Yuan Liang,
  • Wenhua You,
  • Kening Li,
  • Rong Ding,
  • Bin Huang,
  • Lingxiang Wu,
  • Weiwei Duan,
  • Yi Han,
  • Xuesong Li,
  • Xin Tang,
  • Xin Wang,
  • Qianghu Wang,
  • Xinyi Xia,
  • Hongshan Chen,
  • Yong Ji
pengping li
Nanjing Medical University

Corresponding Author:[email protected]

Author Profile
Wei Wu
Nanjing Medical University
Author Profile
Tingting Zhang
Nanjing Medical University
Author Profile
Ziyu Wang
Nanjing Medical University
Author Profile
Ziyu Wang
Nanjing Medical University
Author Profile
Mengyan Zhu
Nanjing Medical University
Author Profile
Yuan Liang
Nanjing Medical University
Author Profile
Wenhua You
Nanjing Medical University
Author Profile
Kening Li
Nanjing Medical University
Author Profile
Rong Ding
Nanjing Medical University
Author Profile
Bin Huang
Nanjing Medical University
Author Profile
Lingxiang Wu
Nanjing Medical University
Author Profile
Weiwei Duan
Nanjing Medical University
Author Profile
Yi Han
Nanjing Medical University
Author Profile
Xuesong Li
Nanjing Medical University
Author Profile
Xin Tang
Nanjing Medical University
Author Profile
Xin Wang
The University of Manchester
Author Profile
Qianghu Wang
Nanjing Medical University
Author Profile
Xinyi Xia
Nanjing University
Author Profile
Hongshan Chen
Nanjing Medical University
Author Profile
Yong Ji
Nanjing Medical University
Author Profile

Abstract

Background and Purpose: Coronavirus disease (COVID-19) has resulted in high mortality worldwide. However, information regarding cardiac markers for precise risk-stratification is limited. We aimed to discover a sensitive and reliable early-warning biomarker for optimizing management and improving COVID-19 patients’ prognosis. Experiments Approach: This retrospectively single-center case series was conducted between February 4 and April 10, 2020. 3,046 consecutive COVID-19 patients who were receiving treatment at Wuhan Huoshenshan Hospital in China were included. Serum levels of cardiac markers and coronary artery disease (CAD) diagnosis were collected after admission. Single-cell RNA-sequencing was performed to analyze severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor expression. Key Results: Median patient age was 60 years; 1,461 (49.5%) were female, and 1,515 (51.3%) were in a severe/critical condition. Compared to mild/moderate patients, severe/critical patients showed significantly higher levels of cardiac markers within the first week after admission. Among severe/critical COVID-19 patients, those with abnormal serum levels of brain natriuretic peptide had a significantly higher mortality than patients with normal levels. Severe/critical COVID-19 patients with pre-existing CAD (165/1,515) had more cases of abnormal brain natriuretic peptide levels than those without CAD. Enhanced SARS-CoV-2 receptor expression was observed in patients with CAD. Regression analysis revealed patients with elevated brain natriuretic peptide were at a higher risk of death. Conclusion and Implications: Brain natriuretic peptide is an effective biomarker for early risk assessment in COVID-19 patients with or without pre-existing CAD. Monitoring BNP status will improve the risk-stratification management and prognosis of patients within one week after admission.
25 Sep 2020Submitted to British Journal of Pharmacology
29 Sep 2020Assigned to Editor
29 Sep 2020Submission Checks Completed